Systemic Challenges in Internship Training for Health-Service Psychology: A Call to Action From Trainee Stakeholders.

The challenges observed in health service psychology (HSP) training during COVID-19 revealed systemic and philosophical issues that preexisted the pandemic, but became more visible during the global health crisis. In a position paper written by 23 trainees across different sites and training specializations, the authors use lessons learned from COVID-19 as a touchstone for a call to action in HSP training. Historically, trainee voices have been conspicuously absent from literature about clinical training. We describe longstanding dilemmas in HSP training that were exacerbated by the pandemic and will continue to require resolution after the pandemic has subsided. The authors make recommendations for systems-level changes that would advance equity and sustainability in HSP training. This article advances the conversation about HSP training by including the perspective of trainees as essential stakeholders.

Inconsistent efficacy of water-soluble amphotericin B for the treatment of Macrorhabdus ornithogaster in a budgerigar (Melopsittacus undulatus) aviary.

OBJECTIVE: To assess the efficacy of a commercially available in-water amphotericin B treatment for Macrorhabdus ornithogaster. DESIGN: Clinical treatment trial. METHODS: Faecal shedding of 16 naturally infected budgerigars (Melopsittacus undulatus) was monitored while they were being treated using in-water amphotericin B, as per the manufacturer's instructions, for 10 days. Any birds that remained positive after 10 days received a further 10 day course of treatment. All birds were rechecked 16 days after the end of the second treatment period. RESULTS: At the conclusion of treatment, 11 birds had stopped shedding M. ornithogaster, and 5 birds were still shedding. Sixteen days after the conclusion of the second treatment period, four birds that were negative after 10 days of treatment were shedding again, and two of the birds that were treated for 20 days were shedding. In addition, one bird from each treatment group died after treatment and before follow-up testing. CONCLUSION: These findings represent a 36% treatment failure, suggesting that treatment with the commercially available, water-soluble amphotericin B has inconsistent efficacy against M. ornithogaster in some budgerigars in Australia and is not effective for eliminating it from budgerigar aviaries.

Patterns of injury amongst cruise ship passengers requiring hospitalisation.

BACKGROUND: The number of commercial cruise ship passengers continues to rise and is projected to reach 27.2 million passengers worldwide in 2018. Accidental injury aboard these ships can result in serious morbidity and mortality. This study examines the injury mechanisms, patterns, demographics, and outcomes of these injuries which are serious enough to require hospitalisation in order to facilitate administrative, financial, and medical decision making to aid in injury prevention and treatment. MATERIALS AND METHODS: This is a cross-sectional, retrospective, registry-based study of adult patients sustaining injury while on a cruise ship admitted to a Level I Trauma Centre in the United States over a 2-year period. Data on demographics, injury type and severity, surgical management, hospital charges, length of stay, mortality, and discharge disposition were recorded. RESULTS: Sixty seven patients were identified and included in the analysis. 70.1% of patients were 65 or older and a majority were female (59.7%). The most common mechanism of injury was a ground level fall (79.1%), and the most common injury encountered was a femur fracture (52.2%) which involved the acetabulo-femoral joint in 85.7% of cases. Traumatic brain injuries were uncommon occurring in 7.5% of cases. There were no fatalities in this series. CONCLUSIONS: The most common injuries aboard cruise ships requiring hospitalisation occur in the geriatric population as a result of a ground level fall. Most commonly, the injuries are long bone fractures, with femur fractures occurring most frequently and accounting for over half of all injuries sustained. Resources and protocols for pre-hospital management of cruise ship injuries should prioritise these patients, and fall prevention measures for this demographic should be mandatory aboard all cruise ships.

Walking Responses of Tribolium castaneum (Coleoptera: Tenebrionidae) to Its Aggregation Pheromone and Odors of Wheat Infestations.

The red flour beetle, Tribolium castaneum (Herbst) (Coleoptera: Tenebrionidae), is a worldwide pest of stored grains. Using "Y"-tube olfactometry we studied the response of T. castaneum to odors from simulated wheat infestations containing conspecifics, and infestations containing the lesser grain borer, Rhyzopertha dominica (F.) (Coleoptera: Bostrichidae), and the granary weevil Sitophilus granarius (L.) (Coleoptera: Curculionidae). Tribolium castaneum larvae were significantly attracted to odors from all three test species. Tribolium castaneum adults were attracted to grains infested by R. dominica and flour infested by T. castaneum but repelled from grains infested by S. granarius. Further behavioral analysis with pheromones showed that T. castaneum were significantly attracted to their aggregation pheromone, dimethyldecanal (DMD), but not to the R. dominica aggregation pheromone, a mixture of dominicalure 1 and 2. Female T. castaneum adults were attracted to ∼50-fold less DMD than larvae and 100-fold less than male adults, suggesting they are more sensitive to DMD. This study improves our understanding of T. castaneum behaviors to infested grain volatile compounds and pheromones, and may help develop new control methods for grain pest species.

Preparing for and responding to recent incursions of raccoon rabies variant into Canada.

By the late 2000s, Canada had successfully eliminated the incursion of racoon rabies from the south and remained free of this rabies variant from approximately 2009 to 2014. However, new incursions of raccoon rabies variant have recently been detected in three Canadian provinces: Ontario, Quebec and New Brunswick. Actions to address previous and current incursions of this rabies variant include enhanced surveillance programs, a point infection control strategy to respond to cases, a trap-vaccine-release program and oral rabies vaccination campaigns in targeted areas to prevent further cases and spread. It is hard to predict when and where new incursions will appear because of the ecological adaptability of raccoons and the significant risk associated with inadvertent translocation events by vehicles, trains and ships and raccoon movements across bridges. To date, no cases of raccoon rabies variant have been detected in domestic animals in Canada. However, until racoon rabies can be pushed back from the Canadian border, it is important to remain prepared for the reappearance of this disease.

A Unifying Model for Capture-Recapture and Distance Sampling Surveys of Wildlife Populations.

A fundamental problem in wildlife ecology and management is estimation of population size or density. The two dominant methods in this area are capture-recapture (CR) and distance sampling (DS), each with its own largely separate literature. We develop a class of models that synthesizes them. It accommodates a spectrum of models ranging from nonspatial CR models (with no information on animal locations) through to DS and mark-recapture distance sampling (MRDS) models, in which animal locations are observed without error. Between these lie spatially explicit capture-recapture (SECR) models that include only capture locations, and a variety of models with less location data than are typical of DS surveys but more than are normally used on SECR surveys. In addition to unifying CR and DS models, the class provides a means of improving inference from SECR models by adding supplementary location data, and a means of incorporating measurement error into DS and MRDS models. We illustrate their utility by comparing inference on acoustic surveys of gibbons and frogs using only capture locations, using estimated angles (gibbons) and combinations of received signal strength and time-of-arrival data (frogs), and on a visual MRDS survey of whales, comparing estimates with exact and estimated distances. Supplementary materials for this article are available online.

Hall probe measurements of the poloidal magnetic field in Compact Toroidal Hybrid plasmas.

A linear array of 16 Hall effect sensors has been developed to directly measure the poloidal magnetic field inside the boundary of a non-axisymmetric hybrid torsatron/tokamak plasma. The array consists of miniature gallium arsenide Hall sensor elements mounted 8 mm apart on a narrow, rotatable printed circuit board inserted into a re-entrant stainless steel tube sheathed in boron nitride. The sensors are calibrated on the bench and in situ to provide accurate local measurements of the magnetic field to aid in reconstructing the equilibrium plasma current density profiles in fully three-dimensional plasmas. Calibrations show that the sensor sensitivities agree with the nominal manufacturers specifications of 1.46 V/T. Poloidal fields measured with the Hall sensor array are found to be within 5% of poloidal fields modeled with a Biot-Savart code.

Design and implementation of a multichannel millimeter wave interferometer for the Compact Toroidal Hybrid experiment.

A three-channel 1 mm wave interferometer has been designed, assembled, and installed on the Compact Toroidal Hybrid torsatron (CTH). The interferometer design makes novel use of a subharmonic mixer for detection, which simplifies alignment. It employs a single electronically tunable source that is repetitively chirped using a sawtooth waveform of frequency up to 1 MHz. The 15.25 GHz drive oscillator is multiplied in two stages to 122 GHz before a final doubler stage brings it to 244 GHz. Local oscillator (LO) power at 122 GHz is directed through waveguide to the LO input of the subharmonic mixer of each viewing chord, simplifying alignment. Phase detection is performed by directly digitizing the amplified mixer outputs at 50 MHz and processing them with a software algorithm. Initial measurements made with the central chord of the new interferometer agree with those from the existing 4 mm system at low densities. The 1 mm system performs well in current-driven discharges reaching densities over 10(19) m(-3), whereas the lower frequency interferometer is found to be less reliable due to loss of fringes. This is a critical improvement for experiments studying the onset, avoidance, and vacuum magnetic transform dependence of disruptions in the CTH device.

Leptospiral uveitis - there is more to it than meets the eye!

Leptospirosis, caused by pathogenic species of genus Leptospira, is a highly prevalent zoonotic disease throughout many parts of the world, and an important emerging disease within the United States. Uveitis is a common complication of systemic infection in humans. A similar condition in horses is characterized by recurrent bouts of inflammation. In this article, we review advances in our understanding of leptospiral uveitis and its pathogenic mechanisms.

Nitrospira-dominated biofilm within a thermal artesian spring: a case for nitrification-driven primary production in a geothermal setting.

Water chemistry, energetic modeling, and molecular analyses were combined to investigate the microbial ecology of a biofilm growing in a thermal artesian spring within Hot Springs National Park, AR. This unique fresh water spring has a low dissolved chemical load and is isolated from both light and direct terrestrial carbon input - resulting in an oligotrophic ecosystem limited for fixed carbon and electron donors. Evaluation of energy yields of lithotrophic reactions putatively linked to autotrophy identified the aerobic oxidation of methane, hydrogen, sulfide, ammonia, and nitrite as the most exergonic. Small subunit (SSU) rRNA gene libraries from biofilm revealed a low-diversity microbial assemblage populated by bacteria and archaea at a gene copy ratio of 45:1. Members of the bacterial family 'Nitrospiraceae', known for their autotrophic nitrite oxidation, dominated the bacterial SSU rRNA gene library (approximately 45%). Members of the Thaumarchaeota ThAOA/HWCGIII (>96%) and Thaumarchaeota Group I.1b (2.5%), which both contain confirmed autotrophic ammonia oxidizers, dominated the archaeal SSU rRNA library. Archaea appear to dominate among the ammonia oxidizers, as only ammonia monooxygenase subunit A (amoA) genes belonging to members of the Thaumarchaeota were detected. The geochemical, phylogenetic, and genetic data support a model that describes a novel thermophilic biofilm built largely by an autotrophic nitrifying microbial assemblage. This is also the first observation of 'Nitrospiraceae' as the dominant organisms within a geothermal environment.

Pre-clinical evaluation of three non-viral gene transfer agents for cystic fibrosis after aerosol delivery to the ovine lung.

We use both large and small animal models in our pre-clinical evaluation of gene transfer agents (GTAs) for cystic fibrosis (CF) gene therapy. Here, we report the use of a large animal model to assess three non-viral GTAs: 25 kDa-branched polyethyleneimine (PEI), the cationic liposome (GL67A) and compacted DNA nanoparticle formulated with polyethylene glycol-substituted lysine 30-mer. GTAs complexed with plasmids expressing human cystic fibrosis transmembrane conductance regulator (CFTR) complementary DNA were administered to the sheep lung (n=8 per group) by aerosol. All GTAs gave evidence of gene transfer and expression 1 day after treatment. Vector-derived mRNA was expressed in lung tissues, including epithelial cell-enriched bronchial brushing samples, with median group values reaching 1-10% of endogenous CFTR mRNA levels. GL67A gave the highest levels of expression. Human CFTR protein was detected in small airway epithelial cells in some animals treated with GL67A (two out of eight) and PEI (one out of eight). Bronchoalveolar lavage neutrophilia, lung histology and elevated serum haptoglobin levels indicated that gene delivery was associated with mild local and systemic inflammation. Our conclusion was that GL67A was the best non-viral GTA currently available for aerosol delivery to the sheep lung, led to the selection of GL67A as our lead GTA for clinical trials in CF patients.

The lupus susceptibility locus Sle3 is not sufficient to accelerate atherosclerosis in lupus-susceptible low density lipoprotein receptor-deficient mice.

Cardiovascular disease risk is increased in individuals suffering from systemic lupus erythematosus. Understanding the mechanism(s) of systemic lupus erythematosus-accelerated atherosclerosis is critical for the development of effective therapies. Our laboratory previously demonstrated that radiation chimeras of systemic lupus erythematosus-susceptible B6.Sle1.2.3 and low density lipoprotein receptor (LDLr)(-/-) mice have augmented atherosclerosis, which is associated with increased T-cell burden and activation in the lesion. The goals of this study were to further define specific immune mechanisms that mediate accelerated atherosclerosis and to determine whether the gene interval Sle3, which is linked to lupus-associated T-cell dysregulation, was sufficient to modulate atherogenesis. We transferred B6.Sle3 or C57Bl/6-derived bone marrow cells into lethally irradiated LDLr( -/-) mice (hereafter referred to as LDLr.Sle3 and LDLr.B6, respectively). Sixteen weeks after transplantation, the mice were placed on a western-type diet for 8 weeks. Our analyses revealed that LDLr.Sle3 mice had increased auto-antibody production against double-stranded DNA and cardiolipin compared with LDLr.B6 controls. We also found an increase in atherosclerosis-associated oxLDL antibodies. Antibody isotypes and serum cytokine analysis suggested that the humoral immune response in LDLr.Sle3 mice was skewed toward a Th2 phenotype. This finding is consistent with lupus-associated immune dysregulation. Additionally, LDLr.Sle3 mice had decreased serum cholesterol and triglyceride levels. However, there was no difference in lesion area or cellular composition of lesions between the two groups. These data demonstrate that, despite no change in lesion area, transfer of Sle3-associated T-cell dysregulation alone to LDLr-deficient mice is sufficient to decrease serum cholesterol and to exacerbate humoral immune responses that are frequently associated with atherosclerosis.

The control of raccoon rabies in Ontario Canada: proactive and reactive tactics, 1994-2007.

Proactive and reactive tactics have been utilized in Ontario, Canada, to prevent raccoon rabies from becoming established. A total of 96,621 raccoons (Procyon lotor) and 7,967 striped skunks (Mephitis mephitis) were live captured using 1,221,044 trap nights, vaccinated against rabies by injection, and released, during proactive Trap-Vaccinate-Release (TVR) programs in southern Ontario during 1994-2007. During those years, on average, 43% to 83% of the raccoon populations were vaccinated against rabies. In addition, 20,129 raccoons and 2,735 skunks were vaccinated against rabies, and 8,311 raccoons and 1,449 skunks were euthanized, using 576,359 trap nights, during reactive Point Infection Control (PIC) operations in eastern Ontario during 1999-2005. A significant correlation was detected between trapping effort and the percentage of the raccoon population that was vaccinated. Between 1999 and 2007, 132 cases of raccoon variant rabies (130 raccoons, two striped skunks) were reported in eastern Ontario. The last case occurred on 23 September 2005 with Ontario being free of reported raccoon rabies to 10 November 2008, proving that TVR and PIC are effective tactics for the control of this disease.

Aerial distribution of ONRAB baits as a tactic to control rabies in raccoons and striped skunks in Ontario, Canada.

During August 2006 and 2007, baits containing oral rabies vaccine, live adenovirus vector, known as ONRAB , were aerially distributed in SW Ontario, Canada. Bait acceptance during 2006 was 62 and 74% in raccoons (Procyon lotor) in areas baited at 150 baits/km(2) and 75 and 77% in plots baited at 300 baits/km(2). During 2007, bait acceptance for raccoons ranged between 59% and 80%, and 83% and 87%, in areas baited at 75 and 400 baits/km(2), respectively. Bait acceptance by skunks varied among plots (5-24%). Rabies virus-specific seroconversion during 2006 averaged 66 and 81% in raccoons in areas baited at 150 and 300 baits/km(2), respectively. During 2007, seroconversion by raccoons was 76 and 84% in areas baited at 75 and 400 baits/km(2), respectively. Seroconversion by skunks varied among plots (17-51%). Vaccine efficacy, as judged by the percentage of animals that consumed a bait and seroconverted, averaged 79 and 87% during 2006 for raccoons in areas baited at 150 and 300 baits/km(2), respectively, and 81 and 90% in areas baited during 2007 at 75 and 400 baits/km(2), respectively. Because tetracycline marking was poor in skunks, an estimate of vaccine efficacy was not possible. Aerial distribution of ONRAB vaccine baits seems to be a feasible tactic for controlling rabies in skunks and raccoons.

Prevalence of tetracycline and rabies virus antibody in raccoons, skunks, and foxes following aerial distribution of V-RG baits to control raccoon rabies in Ontario, Canada.

More than 3.6 million baits containing a recombinant vaccinia virus-rabies glycoprotein (V-RG) oral rabies vaccine were aerially or hand-distributed during 1999-2006 in an approximate 4,000-9,000 km(2) area of eastern Ontario, Canada, as part of a multitactic approach to control the raccoon variant of rabies. The efficacy of the program was assessed through the collection and testing of > 6,900 animals for bait acceptance and rabies virus-specific antibodies. Raccoon acceptance of rabies vaccine baits was significantly greater (71-83% ) in areas baited at a density of 150 baits/km(2) compared to areas baited at 75 baits/km(2) (26-58% ), and more raccoons consumed vaccine baits in areas baited with a flight line spacing of 0.75 km (45.3% [321/708]) than with a spacing of 1.5 km (33.8% [108/320]). In addition, greater numbers of raccoons consumed vaccine baits during a drop in September (52.7% [213/404]) as opposed to a June bait drop (34.6% [216/624]). Seropositivity rates for raccoons ranged between 7% and 28% in areas baited at 75/km(2) and 10% to 27% in areas baited at 150/km(2) with statistical differences varying among years and treatments. The last case of raccoon-variant rabies reported in Ontario was in September 2005. The control of raccoon rabies in Ontario has resulted in an estimated $6M to $10 M Cdn annual savings in rabies-associated costs.

Elimination of arctic variant rabies in red foxes, metropolitan Toronto.

To control the Arctic variant of rabies virus in red foxes, 332,257 bait doses containing live, attenuated Evelyn-Rokitnicki-Abelseth rabies vaccine were distributed in greater metropolitan Toronto during 1989-1999. Human and pet contact with bait was minimal, and no adverse reactions to the vaccine were noted. Significantly fewer rabid foxes were found during the 17 years after fox baiting (5 cases during 1990-2006) than in the 17 years before (96 cases during 1973-1989). The last report of a rabid fox in metropolitan Toronto was in 1996 (reporting period through September 2006), which confirms that distributing oral rabies vaccine bait is a feasible tactic for the control of rabies in foxes in urban environments.

Imaging alcohol cue exposure in alcohol dependence using a PET 15O-H2O paradigm: results from a pilot study.

Craving is a commonly used term to describe an intense desire for a substance or behaviour; however, its underlying neurobiology is not fully characterized. We have successfully used a cue exposure paradigm with functional neuro-imaging (H2 15O PET; PET, positron emission tomography) in abstinent opiate addicts. This study showed that salient cue exposure results in activation in the left anterior cingulate/mediofrontal cortex and elicited craving correlated with activity in the left orbitofrontal cortex. We therefore aimed to replicate this study in alcohol dependence to see if a similar pattern of neural activation occurred. We recruited six abstinent alcohol-dependent and six non-dependent subjects who each underwent a 12-run PET scan using H2 15O to measure changes in regional blood flow during exposure to an alcoholic drink or its visually matched non-alcoholic drink. Physiological data and subjective ratings were also recorded. Statistical parametric mapping (SPM99) was used to analyse the PET images. Compared with control subjects, abstinent alcohol-dependent subjects rated their alcohol craving higher at baseline and throughout the study, but there was no significant change in the scores in response to the cues in either group. SPM analysis across all subjects showed significant activation in the occipital cortex in response to the alcohol cue as compared with the neutral one. Analysis of the same regions that were activated in the opiate study, revealed significant increases in signal activation in the left medial prefrontal area, but only in abstinent alcohol-dependent subjects. In conclusion, in abstinent alcohol dependence we suggest that a simple cue exposure paradigm is not sufficiently powerful in functional imaging studies to determine the underlying neurobiology of subjective craving. Comparisons with the finding in opiate dependence suggest a shared region, the anterior cingulate/left medial prefrontal cortex is involved in the cue response in dependent subjects but not controls.