Attention to Background Strain Is Essential for Metabolic Research: C57BL/6 and the International Knockout Mouse Consortium

The International Knockout Mouse Consortium (IKMC) introduces its targeted constructs into C57BL/6N embryonic stem cells. However, breeding with a Cre-recombinase and/or Flp-recombinase mouse is required for the generation of a null allele with the IKMC cassette. Many recombinase strains are in the C57BL/6J background, resulting in knockout animals on a mixed strain background. This can lead to variability in metabolic data and the use of improper control groups. While C57BL/6N and C57BL/6J are derived from the same parental C57BL/6 strain, there are key genotypic and phenotypic differences between these substrains. Many researchers may not even be aware of these differences, as the shorthand C57BL/6 is often used to describe both substrains. We found that 58% of articles involving genetically modified mouse models did not completely address background strain. This review will describe these two substrains and highlight the importance of separate consideration in mouse model development. Our aim is to increase awareness of this issue in the diabetes research community and to provide practical strategies to enable researchers to avoid mixed strain animals when using IKMC knockout mice.     

Adults in All Body Mass Index Categories Underestimate Daily Energy Requirements

ObjectiveTo compare the difference between self-reported and calculated daily energy requirements of adults within different body mass index (BMI) categories.MethodsAdults (n = 978) self-reported daily energy requirements, demographic information, and height, weight, age, and physical activity level (PAL) to calculate total energy expenditure.ResultsThe main effects of BMI, gender, PAL, and dieting status on the difference between self-reported and calculated energy requirements for weight maintenance were significant (P < .05); age, race/ethnicity, level of education, and being in a health-related field had no effect. Individuals across all BMI categories underestimated their energy requirements, but obese individuals underestimated to the greatest degree. Males, current dieters, and those who reported a low-active or active PAL underestimated to the greatest extent in each category.Conclusions and ImplicationsThere is a lack of basic nutrition knowledge about personal energy needs in individuals across all BMI categories regardless of age, race/ethnicity, level of education, or work/training in a health-related field.     

Towards compassionate care through aesthetic rationality

The Francis Report, which was based on the investigation of complaints regarding standards of care in the Staffordshire NHS Trust in the UK, was published in 2013. The Report revealed that while the Trust appeared to be compliant with the standards set by official regulating bodies, the quality of care provided to patients was often appalling. While the Report constituted a ‘critical moment’ in health care, its findings resonated with widespread concern in the UK and elsewhere that health care is sometimes characterised by a lack of compassion. The Francis Report partially attributed this lack of compassion to a task‐based culture which tended to prioritise the meeting of targets over the quality of care provided to patients. Older patients, in particular, were identified as being vulnerable to neglect. This qualitative study of hospice volunteers responds to concerns regarding the quality of organisational forms of care by considering how motivations to care may be sustained and enhanced within organisational contexts. Charitable and third sector organisations, such as the hospice in this study, have been identified as potentially relevant to other health and social care contexts precisely because they emphasise values such as altruism and goodwill. Our sociological approach suggests that altruism or compassion can be encouraged within contexts that emphasise a sociability of care. We argue that a sociability of care may be encouraged in organisational contexts if dominant understandings of rationality are extended through the incorporation of aesthetic rationality, a feminist perspective taken from Roslyn Bologh. This, however, would require a degree of authentic emotional engagement on the part of formal caregivers, which is more typically associated with relationships in the private sphere.     

Specific Words and Experience Matter to Surrogates When Making End of Life Decisions

This grant funded preliminary study investigated the relationship between end-of-life terminologies and decisional conflict in surrogate decision makers using a convenience sample of 234 adults aged 50 and older. Participants were randomized into two groups; each received a survey packet that varied only in the use of the words “Do Not Resuscitate (DNR)” and “Allow Natural Death (AND).” The Decisional Conflict Scale (DCS) was administered and demographic data were collected. No difference was found in the total DCS scores based on the AND and DNR versions. However, AND respondents perceived their decision as a good decision and were eight times more likely to sign the document than DNR participants. Experienced decision-makers evolved as a discrete group. They had lower mean total DCS scores and lower mean subscores, indicating that prior experience is an important aspect of end-of-life decision-making. Experienced AND participants were more likely to perceive their decision as good and were more likely to be sure of their decision, indicating that they respond more favorably to the words Allow Natural Death. Respondents to the DNR version were likely to not sign or postpone signing. Those who frequently attended religious services were twice as likely as those who rarely attend religious services of implementing their decision; whether the decision is to sign or not to sign the AND or DNR. Finally, participants were more likely to withdraw from the study when the term DNR was used. Recommendations for future research are presented.