Development and application of an oral challenge mouse model for studying Clostridium perfringens type D infection

Clostridium perfringens type D isolates cause enterotoxemia in sheep, goats, and probably cattle. While the major disease signs and lesions of type D animal disease are usually attributed to epsilon toxin, a class B select agent, these bacteria typically produce several lethal toxins. Understanding of disease pathogenesis and development of improved vaccines are hindered by the lack of a small-animal model mimicking natural disease caused by type D isolates. Addressing this need, we developed an oral challenge mouse model of C. perfringens type D enterotoxemia. When BALB/c mice with a sealed anus were inoculated by intragastric gavage with type D isolates, 7 of 10 type D isolates were lethal, as defined by spontaneous death or severe clinical signs necessitating euthanasia. The lethalities of the seven type D isolates varied between 14 and 100%. Clinical signs in the lethally challenged mice included seizures, convulsions, hyperexcitability, and/or depression. Mild intestinal gas distention and brain edema were observed at necropsy in a few mice, while histology showed multifocal acute tubular necrosis of the kidney and edema in the lungs of most challenged mice that developed a clinical response. When the lethality of type D isolates in this model was compared with in vitro toxin production, only a limited correlation was observed. However, mice could be protected against lethality by intravenous passive immunization with an epsilon toxin antibody prior to oral challenge. This study provides an economical new model for studying the pathogenesis of C. perfringens type D infections.     

Teachers' perceptions of and responses to adolescents with chronic pain syndromes

OBJECTIVE: To examine factors that influence teachers' perceptions of and responses to chronic pain in students. METHODS: Two-hundred and sixty classroom teachers responded to a vignette describing a student with limb pain. The 2 x 2 x 2 factorial design included conditions that varied by (a) the presence or absence of documented organic evidence for the pain, (b) cooperative vs. confrontational parent-teacher interactions, and (c) the presence or absence of communication from the medical team. Teachers rated pain severity and impairment, relief from classroom responsibilities, extent of accommodations the student would require in school, and sympathy for the student and family. RESULTS: Documented medical evidence supporting the pain was the most influential factor affecting teachers' responses to pain. Parental attitude also influenced responses. Communication from the medical team influenced teachers' decisions about relief from responsibilities but did not affect other reactions. CONCLUSIONS: Teachers' responses to students with pain are influenced by situational factors. Efforts to increase school functioning in youth with chronic pain should incorporate attempts to help teachers respond to pain adaptively.     

Modified Version of Baby-Led Weaning Does Not Result in Lower Zinc Intake or Status in Infants: A Randomized Controlled Trial

Background

Little is known about zinc intakes and status during complementary feeding. This is particularly true for baby-led approaches, which encourage infants to feed themselves from the start of complementary feeding, although self-feeding may restrict the intake of zinc-rich foods.

Participant Satisfaction with a Food Benefit Program with Restrictions and Incentives

Background

Policy makers are considering changes to the Supplemental Nutrition Assistance Program (SNAP). Proposed changes include financially incentivizing the purchase of healthier foods and prohibiting the use of funds for purchasing foods high in added sugars. SNAP participant perspectives may be useful in understanding the consequences of these proposed changes.

Codesigned recommendations for increasing engagement in structured physical activity for people with serious mental health problems in Australia

People with mental health problems are at higher risk of physical health comorbidities and early mortality. A key risk factor for poor health outcomes is a lack of regular physical activity. Mental health services have typically responded by focusing on screening and promoting lifestyle programmes within secondary care mental health settings. The aim of this study was to better understand the barriers and enablers for Australian mental health consumers to participate in physical activity or exercise programmes from the perspectives of consumers and exercise practitioners. Interviews with 15 consumers experiencing serious mental health problems and five exercise practitioners were undertaken, followed by two focus groups (involving eight consumers and two exercise practitioners) to gain consensus on themes from the interviews, and codesign a set of recommendations for services to support and increase the engagement of mental health consumers in regular community‐based exercise. Barriers that impacted on engagement in physical activity included: lack of social support, insufficient knowledge and information, difficulties with work/life balance, impact of physical and mental health issues, fear and lack of confidence, and financial cost. Enablers or motivators assisting engagement in community‐based physical activity programmes included: social support, access to person‐centred individualised exercise options, connection and a sense of belonging, and access to information and education. Recommendations and a checklist were developed to assist services to increase the involvement of mental health consumers in community‐based exercise and to ensure that exercise practitioners and their employing organisations are adequately equipped to work with this population.     

Mid-term outcomes of surgical management of complex,isolated radial head fractures: a multicentre collaboration

European Journal of Orthopaedic Surgery & Traumatology - The available literature discussing optimal surgical management of Mason II and III radial head (RH) fractures without concomitant bone...     

Prospective randomized controlled trial comparing cephalad migration in robotic gynecologic surgery using egg-crate foam versus the Pink Pad®

Journal of Robotic Surgery - The objectives of the study were to compare the cephalad migration of two patient positioning pads used in robotic gynecologic surgery and to determine if any...