APOε2 and education in cognitively normal older subjects with high levels of AD pathology at autopsy: findings from the Nun Study

Asymptomatic Alzheimer''s disease (ASYMAD) subjects are individuals characterized by preserved cognition before death despite substantial AD pathology at autopsy. ASYMAD subjects show comparable levels of AD pathology, i.e. β-amyloid neuritic plaques (Aβ-NP) and tau-neurofibrillary tangles (NFT), to those observed in mild cognitive impairment (MCI) and some definite AD cases. Previous clinicopathologic studies on ASYMAD subjects have shown specific phenomena of hypertrophy in the cell bodies, nuclei, and nucleoli of hippocampal pyramidal neurons and other cerebral areas. Since it is well established that the allele APOε4 is a major genetic risk factor for AD, we examined whether specific alleles of APOE could be associated with the different clinical outcomes between ASYMAD and MCI subjects despite equivalent AD pathology. A total of 523 brains from the Nun Study were screened for this investigation. The results showed higher APOε2 frequency (p < 0.001) in ASYMAD (19.2%) vs. MCI (0%) and vs. AD (4.7%). Furthermore, higher education in ASYMAD vs. MCI and AD (p < 0.05) was found. These novel autopsy-verified findings support the hypothesis of the beneficial effect of APOε2 and education, both which seem to act as contributing factors in delaying or forestalling the clinical manifestations of AD despite consistent levels of AD pathology.     

For Everything There Is a Season

Describes the “seasons” of professional life and conscious decision-making regarding role changes.     

Gender and distribution of educational values among the staff in kindergartens

The article reports and reflects on a study of kindergarten staff member’s gendered attitudes. The empirical part consists of answers to a questionnaire from some 700 staff members of all 80 kindergartens in two Danish municipalities. The theoretical approach is informed by the framework of Pierre Bourdieu and the Mary Douglas’ Grid Group Cultural Theory. The common strong point of view is that men are an exceptional educational resource in kindergartens and for the sake of gender equality on the labour market, one is to promote a higher proportion of male workers in kindergartens and in several other sectors, where women commonly are in the majority. We examine these premises in respect of Denmark and Norway and then confront the notion of kindergartens to be gender-segregated in pedagogical and professional terms. In conclusion, it is proposed a renewal of the starting point of the educational gender research.     

Energy expenditure during physiotherapist-assisted and self-treatment in cystic fibrosis

Cystic fibrosis (CF) results in increased energy requirements at rest. However, the energy expended during physiotherapy management is unknown. The aim of this study, therefore, is to examine the energy expended during two commonly used forms of chest physiotherapy in CF subjects. Twenty-six CF subjects completed a randomised crossover trial with 48 hours between treatments. Two regimens of treatment were conducted: therapist-assisted treatment (active cycle of breathing, ACBT, with percussion, vibration), and independent treatment (ACBT alone, under the supervision of a physiotherapist). Subjects completed pulmonary function tests before and after either treatment. Indirect calorimetry and oximetry parameters were recorded at rest, during, and following treatment. Treatment groups were compared using ANOVA and two-sample crossover t-tests. When compared to resting values, physiotherapy treatment resulted in significant increases in VO₂, VCO₂ and respiratory exchange ratio. No difference was evident between treatment regimens for the change in VO₂ between baseline and treatment. The increase in ventilation (baseline to treatment) was significantly greater for the therapist-assisted treatment. The therapist-assisted ACBT was associated with a significant carryover effect for forced expiratory flow at 50% of vital capacity (FEF₅₀). Oxygen requirements for the two treatments were similar. However, the assisted regimen resulted in greater changes in minute ventilation during treatment and improved 48-hour post-treatment pulmonary function after only one treatment session. These findings suggest that the inclusion of percussion and vibration within the ACBT may influence respiratory muscle activity during treatment and result in improved pulmonary function.     

Complex Issues Affecting Student Pharmacist Debt

It is time for colleges and schools of pharmacy to examine and confront the rising costs of pharmacy education and the increasing student loan debt borne by graduates. These phenomena likely result from a variety of complex factors. The academy should begin addressing these issues before pharmacy education becomes cost-prohibitive for future generations. This paper discusses some of the more salient drivers of cost and student debt load and offers suggestions that may help alleviate some of the financial pressures.     

Health Care Providers' Perceptions of the Elderly and Level of Interest in Geriatrics as a Specialty

This study has examined knowledge of the elderly, as measured by the FOA Quiz, and levels of interest in geriatrics for samples of health care students and practitioners in North Carolina. Groups studied included medical students, physician's assistant students, practicing physician's assistants, family physicians, family practice residents, and dentists. Results of the study indicated (1) a relatively low level of interest in geriatrics as a specialty, with medical students reporting the lowest interest; (2) considerable similarity both between and within groups with respect to overall knowledge and perceptions, and also in terms of specific errors in knowledge; and (3) prior experience with the elderly (before entering school or practice) is positively related to interest in geriatrics for both students and practitioners. Multivariate analyses of other background characteristics identified additional variables predictive of knowledge and interest in geriatrics.