Perceptions of intimidation in the psychiatric educational environment in Edmonton, Alberta.

OBJECTIVE: To examine the perceptions of intimidation in the psychiatric educational environment in Edmonton, Alberta. METHODS: We distributed a 7-point modified Likert scale questionnaire that included questions with respect to intimidation perceptions and experience in psychiatry during a 1-week period to all student interns on psychiatry rotations, residents, and teaching faculty in the 5 teaching hospitals in Edmonton. RESULTS: A total of 92 individuals responded, with response rates of 81% for faculty, 82% for residents, and 84% for students. Response rates did not differ among sites. While there were differences between site and group with respect to comparing the perceived intimidation in psychiatry with other specialties, respondents did not view psychiatry as worse than other specialties. Although, overall, women perceived intimidation as more prevalent at their sites than did men, the overall means reflect sites that are relatively free from intimidation. Faculty and student interns within sites, except for the university hospital, tended to disagree on management's approach to perceived intimidation. All groups, however, reported little personal experience and felt their sites had little tolerance for intimidators. CONCLUSIONS: Reported perceptions and personal experiences of intimidation within the psychiatric learning environment in Edmonton are low.     

Investigating cellulose derived glycosaminoglycan mimetic scaffolds for cartilage tissue engineering applications

Articular cartilage has a limited capacity to heal and, currently, no treatment exists that can restore normal hyaline cartilage. Creating tissue engineering scaffolds that more closely mimic the native extracellular matrix may be an attractive approach. Glycosaminoglycans, which are present in native cartilage tissue, provide signalling and structural cues to cells. This study evaluated the use of a glycosaminoglycan mimetic, derived from cellulose, as a potential scaffold for cartilage repair applications. Fully sulfated sodium cellulose sulfate (NaCS) was initially evaluated in soluble form as an additive to cell culture media. Human mesenchymal stem cell (MSC) chondrogenesis in pellet culture was enhanced with 0.01% NaCS added to induction media as demonstrated by significantly higher gene expression for type II collagen and aggrecan. NaCS was combined with gelatine to form fibrous scaffolds using the electrospinning technique. Scaffolds were characterized for fibre morphology, overall hydrolytic stability, protein/growth factor interaction and for supporting MSC chondrogenesis in vitro. Scaffolds immersed in phosphate buffered saline for up to 56 days had no changes in swelling and no dissolution of NaCS as compared to day 0. Increasing concentrations of the model protein lysozyme and transforming growth factor‐β3 were detected on scaffolds with increasing concentrations of NaCS (p < 0.05). MSC chondrogenesis was enhanced on the scaffold with the lowest NaCS concentration as seen with the highest collagen type II production, collagen type II immunostaining, and expression of cartilage‐specific genes. These studies demonstrate the feasibility of cellulose sulfate as a scaffolding material for cartilage tissue engineering. Copyright © 2016 John Wiley & Sons, Ltd.     

Use of designing for behaviour change framework in identifying and addressing barriers to and enablers of animal source feeding to children ages 8–23 months in Bandarban Hill District in Bangladesh: Implications for a nutrition-sensitive agriculture programme

Inadequate diet quality is a cause of undernutrition among children 6–23 months of age in Bangladesh, particularly in remote and isolated areas such as Bandarban District. Feeding animal source foods can help to combat stunting and wasting problems among children, but it may not be accessible or acceptable. A barrier analysis using the Designing for Behavior Change Framework was conducted in Bandarban district with participants from 4 ethnic groups, to explore potential barriers and key motivators by examining 12 behavioural determinants of consumption of animal-source food in complementary feeding for children 8–23 months. Data were collected from 45 mothers of children 8–23 months, who provided animal-source foods to their children (doers), and from 45 mothers who did not (non-doers), for a total of 90 interviews. Nine determinants were statistically significantly different between doers and non-doers as follows: self-efficacy, positive consequences, negative consequences, social norms, access, reminders, perceived risk, perceived severity and perceived action efficacy. Nearby access to purchase animal-source foods, rearing poultry or livestock at home and the support of household and community members are enablers to feeding animal-source food. In contrast, these same factors are barriers for non-doers. The lack of money to spend on animal-source foods is also a barrier. An integrated nutrition-sensitive and gender-transformative animal-based food production, and inclusive market programme could increase access to meat and eggs at the household level, increase opportunities to earn income and support gender-equitable household workloads and decision-making for optimal child feeding.     

Mycosphaerella and Teratosphaeria diseases of Eucalyptus; easily confused and with serious consequences

The Mycosphaerella complex accommodates thousands of taxa. Many of these species are economically important plant pathogens, notably on native and commercially propagated Eucalyptus species where they cause a wide range of disease symptoms including leaf spot, leaf blotch, shoot blight and stem cankers. Some of these diseases represent major impediments to sustainable Eucalyptus forestry in several countries where infection by Mycosphaerella and Teratosphaeria species can result in reduction of wood volume and in severe cases tree death. Extensive research has been conducted on these disease complexes over the past 40 years. The incorporation of DNA-based molecular techniques has made it possible to define and to better understand the differences between the Mycosphaerella and Teratosphaeria species occurring on Eucalyptus. These studies have also enabled refinement of anamorph and teleomorph generic concepts for the genera and thus facilitated the more accurate identification of species. They have also promoted a more lucid understanding of the biology, life cycles, population biology and epidemiology of the most important pathogens in the group.     

Mutagenicity and toxicity of the DNA alkylation carcinogens 1, 2-dimethylhydrazine and azoxymethane in Escherichia coli and Salmonella typhimurium

DNA alkylating agents such as 1, 2-dimethylhydrazine (SDMH)and azoxymethane (AOM) are potent carcinogens and are widelyused to induce colon tumors in experimental animals. However,standard bacterial mutagenesis assays have failed to detectthe mutagenic effects of these chemicals. Using derivativesof a set of Escherichia coli test strains developed by Cupplesand Miller (Proc. NatL Acad. Set USA, 86, 5345, 1989), we havedemonstrated that under two conditions, SDMH and AOM inducedpoint mutations by several-fold in a dose-dependent manner:(i) of six possible base substitutions, they only induced GC     

Legitimizing diabetes as a community health issue: a case analysis of an Aboriginal community in Canada

The Kahnawake Schools Diabetes Prevention Project (KSDPP) is an ongoing participatory research and intervention project aimed at the primary prevention of type 2 diabetes. Formally initiated in 1994 with strong community support, KSDPP provides a fertile opportunity to learn about how a community came to identify the need for preventive action on a health problem such as diabetes. The purpose of our study was to describe the various conditions in the community of Kahnawake, which gave rise to its mobilization for the prevention of type 2 diabetes. Qualitative data consisted of 12 individual interviews and one focus group with key community members and health professionals living and/or working in the community of Kahnawake, along with historically relevant documents. The data collection and analysis procedures of the grounded theory method were applied. Results describe a preceding phase to formal KSDPP implementation, triggered by returning research results on the community prevalence of type 2 diabetes. This phase of 'legitimizing diabetes as a community health issue' is characterized by a shift in the perceived preventability of diabetes among community members; from a problem that was to be lived with to a problem that was to be prevented. The shift in perceptions was facilitated by the context in the community, described by structural developments, cognitive and relational elements. In addition to reaffirming the critical importance of utilizing lay knowledge during the planning of a health promotion intervention, our study has uncovered some of the key conditions through which individuals in the community came to participate in the identification and planning of a diabetes prevention project.     

Food and eating as social practice – understanding eating patterns as social phenomena and implications for public health

Globally, public health agencies recognise obesity trends among populations as a priority. Explanations for population obesity patterns are linked to obesogenic environments and societal trends which encourage patterns of overeating and little physical activity. However, obesity prevention and nutrition intervention focus predominantly on changing individual level eating behaviours. Disappointingly, behaviour‐based nutrition education approaches to changing population eating patterns have met with limited success. Sociological perspectives propose that underlying social relations can help explain collective food and eating patterns, and suggest an analysis of the sociocultural context for understanding population eating patterns. We propose a theoretical framework for the examination of eating patterns as social phenomena. Giddens’ structuration theory, in particular his concept of social practices understood as an interplay of ‘agency’ and ‘social structure’ (rules and resources), is used to study food choice patterns. We discuss the application of these concepts for understanding routine food choice practices of families, elaborating how rules and resources configure the enabling or constraining conditions under which actors make food choices. The framework assists in characterising how social structural properties are integral to food choice practices, and could direct attention to these when considering nutrition interventions aimed at changing population eating patterns.     

DNA mismatch repair mutants do not increase N-methyl-N'-nitro- N-nitrosoguanidine tolerance in O6-methylguanine DNA methyltransferase-deficient yeast cells

Treatment of cells with N-methyl-N' -nitro-N-nitrosoguanidine(MNNG) produces, among other lesions, mutagenic and carcinogeniclesions such as O⁴-methylthymine in DNA. An OMeG DNA methyltransferase(MTase) specifically and efficiently repairs such lesions. MTase-deficientbacterial, yeast and mammalian induced mutagenesis, but alsoto MNNG-induced killing, suggesting that O⁶MEG-type lesionsare also lethal to the cells. The lethal effect caused by Ois not clear. Results from several recent experiments indicatethat some MNNG-tolerant cell lines exhibit a loss of DNA mismatchbinding/repair activity, suggesting that functional mismatchrepair is probably responsible for the cellular sensitivityto DNA methylating agents. We tested this abortive O⁶MeG T mismatchrepair hypothesis in a well-defined lower eukaryote, Saccharomycescerevisiae. We found that while mgt1 -deleted MTase-deficientyeast strains are hypersensitive to MINNG-induced killing, combinationof this mutation with any of the mlh1, msh2 or pins1 mutationsdid not render cells more tolerant to killing.msh3 mutationalso did not rescue MNNG-induced genotoxicity. Furthermore,through the isolation and characterization of MINNG tolerantcell lines from the MTase-deficient mutants we demonstratedthat a DNA mismatch repair defect is neither sufficient norrequired for this process. Since both DNA repair MTases andmismatch repair proteins are highly conserved between yeastand manunalian cells, our results could suggest alternativemechanisms in the cellular toler ance to O⁶MeG-induced killing.     

Mutational analysis in UK patients with a clinical diagnosis of familial hypercholesterolaemia: relationship with plasma lipid traits, heart disease risk and utility in relative tracing

As part of a randomised trial [Genetic Risk Assessment for Familial Hypercholesterolaemia (FH) Trial] of the psychological consequences of DNA-based and non-DNA-based diagnosis of FH, 338 probands with a clinical diagnosis of FH (46% with tendon xanthomas) were recruited. In the DNA-based testing arm (245 probands), using single-strand conformation polymorphism of all exons of the low-density lipoprotein receptor (LDLR) gene, 48 different pathogenic mutations were found in 62 probands (25%), while 7 (2.9%) of the patients had the R3500Q mutation in the apolipoprotein B (APOB) gene. Compared to those with no detected mutation, mean untreated cholesterol levels in those with the APOB mutation were similar, while in those with an LDLR mutation levels were significantly higher (None=9.15±1.62 vs LDLR=9.13±1.16 vs APOB=10.26±2.07 mmol/l p<0.001, respectively). Thirty seven percent of the detected mutations were in exon 3/4 of LDLR, and this group had significantly higher untreated cholesterol than those with other LDLR mutations (11.71±2.39 mmol/l vs 9.88±2.44 mmol/l, p=0.03), and more evidence of coronary disease compared to those with other LDLR or APOB mutations (36 vs 13% p=0.04). Of the probands with a detected mutation, 54 first-degree relatives were identified, of whom 27 (50%) had a mutation. Of these, 18 had untreated cholesterol above the 95th percentile for their age and gender, but there was overlap with levels in the non-carrier relatives such that 12% of subjects would have been incorrectly diagnosed on lipid levels alone. In the non-DNA-based testing arm (82 probands) only 19 of the 74 relatives identified had untreated cholesterol above the 95th percentile for their age and gender, which was significantly lower (p<0.0005) than the 50% expected for monogenic inheritance. These data confirm the genetic heterogeneity of LDLR mutations in the UK and the deleterious effect of mutations in exon 3 or 4 of LDLR on receptor function, lipids and severity of coronary heart disease. In patients with a clinical diagnosis of FH but no detectable mutation, there is weaker evidence for a monogenic cause compared with relatives of probands with LDLR mutations. This supports the usefulness of DNA testing to confirm diagnosis of FH for the treatment of hyperlipidaemia and for further cascade screening.     

Producing decisions in service-user groups for people with an intellectual disability: two contrasting facilitator styles

Service-user groups whose goals include the promotion of self-advocacy for people with an intellectual disability aim, among other things, to encourage service users to identify problems and find solutions. However, service users' contributions to group sessions may not always be full and spontaneous. This presents a dilemma to the facilitator. In two case studies, we identify two ways in which the dilemma is managed. In one case, the facilitator takes an initiating role in each stage of a decision-making cycle. In the other, the facilitator short-circuits the decision-making cycle. The former seems to be closer to the philosophy of self-advocacy, but both nevertheless result in clients not taking the initiative and arguably disempowers them.