A project to improve the information seeking skills and increase the use of evidence-based research in public health practice

The ability of public health practitioners (PHPs) to work efficiently and effectively is negatively impacted by their lack of knowledge of the broad range of evidence-based practice information resources and tools that can be utilized to guide them in their development of health policies and programs. This project, a three-hour continuing education hands-on workshop with supporting resources, was designed to increase knowledge and skills of these resources. The workshop was presented as a pre-conference continuing education program for the Texas Public Health Association (TPHA) 2008 Annual Conference. Topics included: identification of evidence-based practice resources to aid in the development of policies and programs; identification of sources of publicly available data; utilization of data for community assessments; and accessing and searching the literature through a collection of databases available to all citizens of Texas. Supplemental resources included a blog that served as a gateway to the resources explored during the presentation, a community assessment workbook that incorporates both Healthy People 2010 objectives and links to reliable sources of data, and handouts providing additional instruction on the use of the resources covered during the workshop.^ Before- and after-workshop surveys based on Kirkpatrick's 4-level model of evaluation and the Theory of Planned Behavior were administered. Of the questions related to the trainer, the workshop, and the usefulness of the workshop, participants gave "Good" to "Excellent" responses to all one question. Confidence levels overall increased a statistically significant amount; measurements of attitude, social norms, and control showed no significant differences before and after the workshop. Lastly, participants indicated they were likely to use resources shown during the workshop within a one to three month time period on average. ^ The workshop and creation of supplemental resources served as a pilot for a funded project that will be continued with the development and delivery of four 4-week long webinar-based training sessions to be completed by December 2008. ^

Enhancers increase the probability but not the level of gene expression.

We have studied enhancer function in transient and stable expression assays in mammalian cells by using systems that distinguish expressing from nonexpressing cells. When expression is studied in this way, enhancers are found to increase the probability of a construct being active but not the level of expression per template. In stably integrated constructs, large differences in expression level are observed but these are not related to the presence of an enhancer. Together with earlier studies, these results suggest that enhancers act to affect a binary (on/off) switch in transcriptional activity. Although this idea challenges the widely accepted model of enhancer activity, it is consistent with much, if not all, experimental evidence on this subject. We hypothesize that enhancers act to increase the probability of forming a stably active template. When randomly integrated into the genome, enhancers may affect a metastable state of repression/activity, permitting expression in regions that would not permit activity of an isolated promoter.

A Q-Methodology approach to investigating the relationship between level of reflection and typologies among prospective teachers in the physics learning assistant program at Florida International University

The purpose of this mixed methods study was to understand physics Learning Assistants' (LAs) views on reflective teaching, expertise in teaching, and LA program teaching experience and to determine if views predicted level of reflection evident in writing. Interviews were conducted in Phase One, Q methodology was used in Phase Two, and level of reflection in participants' writing was assessed using a rubric based on Hatton and Smith's (1995) "Criteria for the Recognition of Evidence for Different Types of Reflective Writing" in Phase Three. Interview analysis revealed varying perspectives on content knowledge, pedagogical knowledge, and experience in relation to expertise in teaching. Participants revealed that they engaged in reflection on their teaching, believed reflection helps teachers improve, and found peer reflection beneficial. Participants believed teaching experience in the LA program provided preparation for teaching, but that more preparation was needed to teach. Three typologies emerged in Phase Two. Type One LAs found participation in the LA program rewarding and believed expertise in teaching does not require expertise in content or pedagogy, but it develops over time from reflection. Type Two LAs valued reflection, but not writing reflections, felt the LA program teaching experience helped them decide on non-teaching careers and helped them confront gaps in their physics knowledge. Type Three LAs valued reflection, believed expertise in content and pedagogy are necessary for expert teaching, and felt LA program teaching experience increased their likelihood of becoming teachers, but did not prepare them for teaching. Writing assignments submitted in Phase Three were categorized as 19% descriptive writing, 60% descriptive reflections, and 21% dialogic reflections. No assignments were categorized as critical reflection. Using ordinal logistic regression, typologies that emerged in Phase Two were not found to be predictors for the level of reflection evident in the writing assignments. In conclusion, viewpoints of physics LAs were revealed, typologies among them were discovered, and their writing gave evidence of their ability to reflect on teaching. These findings may benefit faculty and staff in the LA program by helping them better understand the views of physics LAs and how to assess their various forms of reflection.

Is the activity level of HD 80606 influenced by its eccentric planet?

Aims: Several studies suggest that the activity level of a planet-host star can be influenced by the presence of a close-by orbiting planet. Moreover, the interaction mechanisms that have been proposed, magnetic interaction and tidal interaction, exhibit a very different dependence on the orbital separation between the star and the planet. A detection of activity enhancement and characterization of its dependence on planetary orbital distance can, in principle, allow us to characterize the physical mechanism behind the activity enhancement. Methods: We used the HARPS-N spectrograph to measure the stellar activity level of HD 80606 during the planetary periastron passage and compared the activity measured to that close to apastron. Being characterized by an eccentricity of 0.93 and an orbital period of 111 days, the system's extreme variation in orbital separation makes it a perfect target to test our hypothesis. Results: We find no evidence for a variation in the activity level of the star as a function of planetary orbital distance, as measured by all activity indicators employed: log(R'HK), Hα, NaI, and HeI. None of the models employed, whether magnetic interaction or tidal interaction, provides a good description of the data. The photometry revealed no variation either, but it was strongly affected by poor weather conditions. Conclusions: We find no evidence for star-planet interaction in HD 80606 at the moment of the periastron passage of its very eccentric planet. The straightforward explanation for the non-detection is the absence of interaction as a result of a low magnetic field strength on either the planet or the star and of the low level of tidal interaction between the two. However, we cannot exclude two scenarios: i) the interaction can be instantaneous and of magnetic origin, being concentrated on the substellar point and its surrounding area; and ii) the interaction can lead to a delayed activity enhancement. In either scenario, a star-planet interaction would not be detectable with the dataset described in this paper.

Affordances and Language: How the Level of Object Familiarity modulates the Manipulation and Categorization of Objects across Development

According to much evidence, observing objects activates two types of information: structural properties, i.e., the visual information about the structural features of objects, and function knowledge, i.e., the conceptual information about their skilful use. Many studies so far have focused on the role played by these two kinds of information during object recognition and on their neural underpinnings. However, to the best of our knowledge no study so far has focused on the different activation of this information (structural vs. function) during object manipulation and conceptualization, depending on the age of participants and on the level of object familiarity (familiar vs. non-familiar). Therefore, the main aim of this dissertation was to investigate how actions and concepts related to familiar and non-familiar objects may vary across development. To pursue this aim, four studies were carried out. A first study led to the creation of the Familiar and Non-Familiar Stimuli Database, a set of everyday objects classified by Italian pre-schoolers, schoolers, and adults, useful to verify how object knowledge is modulated by age and frequency of use. A parallel study demonstrated that factors such as sociocultural dynamics may affect the perception of objects. Specifically, data for familiarity, naming, function, using and frequency of use of the objects used to create the Familiar And Non-Familiar Stimuli Database were collected with Dutch and Croatian children and adults. The last two studies on object interaction and language provide further evidence in support of the literature on affordances and on the link between affordances and the cognitive process of language from a developmental point of view, supporting the perspective of a situated cognition and emphasizing the crucial role of human experience.

Minimal Invasive Ostheosintesis For Treatment Of Diaphiseal Transverse Humeral Shaft Fractures.

To evaluate patients with transverse fractures of the shaft of the humerus treated with indirect reduction and internal fixation with plate and screws through minimally invasive technique. Inclusion criteria were adult patients with transverse diaphyseal fractures of the humerus closed, isolated or not occurring within 15 days of the initial trauma. Exclusion criteria were patients with compound fractures. In two patients, proximal screw loosening occurred, however, the fractures consolidated in the same mean time as the rest of the series. Consolidation with up to 5 degrees of varus occurred in five cases and extension deficit was observed in the patient with olecranon fracture treated with tension band, which was not considered as a complication. There was no recurrence of infection or iatrogenic radial nerve injury. It can be concluded that minimally invasive osteosynthesis with bridge plate can be considered a safe and effective option for the treatment of transverse fractures of the humeral shaft. Level of Evidence III, Therapeutic Study.

Fracture Of Distal Humerus: Mipo Technique With Visualization Of The Radial Nerve.

To evaluate the outcomes in patients treated for humerus distal third fractures with MIPO technique and visualization of the radial nerve by an accessory approach, in those without radial palsy before surgery. The patients were treated with MIPO technique. The visualization and isolation of the radial nerve was done by an approach between the brachialis and the brachiorradialis, with an oblique incision, in the lateral side of the arm. MEPS was used to evaluate the elbow function. Seven patients were evaluated with a mean age of 29.8 years old. The average follow up was 29.85 months. The radial neuropraxis after surgery occurred in three patients. The sensorial recovery occurred after 3.16 months on average and also of the motor function, after 5.33 months on average, in all patients. We achieved fracture consolidation in all patients (M=4.22 months). The averages for flexion-extension and prono-supination were 112.85° and 145°, respectively. The MEPS average score was 86.42. There was no case of infection. This approach allowed excluding a radial nerve interposition on site of the fracture and/or under the plate, showing a high level of consolidation of the fracture and a good evolution of the range of movement of the elbow. Level of Evidence IV, Case Series.

Weight of evidence

Evidence-based Medicine (EBM) has become a major source of medical knowledge. It handles complexities of virtually every method or technique used in research. The knowledge on how the EBM researcher retrieves information, judges for relevance and analyzes derived data is invaluable for the skillful reader of medical scientific reports.

Plasmodium vivax: Induction of CD4(+)CD25(+)FoxP3(+) Regulatory T Cells during Infection Are Directly Associated with Level of Circulating Parasites

Circulation CD4(+)CD25(+)FoxP3(+) regulatory T cells (Tregs) have been associated with the delicate balancing between control of overwhelming acute malaria infection and prevention of immune pathology due to disproportionate inflammatory responses to erythrocytic stage of the parasite. While the role of Tregs has been well-documented in murine models and P. falciparum infection, the phenotype and function of Tregs in P. vivax infection is still poorly characterized. In the current study, we demonstrated that patients with acute P. vivax infection presented a significant augmentation of circulating Tregs producing anti-inflammatory (IL-10 and TGF-beta) as well as pro-inflammatory (IFN-gamma, IL-17) cytokines, which was further positively correlated with parasite burden. Surface expression of GITR molecule and intracellular expression of CTLA-4 were significantly upregulated in Tregs from infected donors, presenting also a positive association between either absolute numbers of CD4(+)CD25(+)FoxP3(+)GITR(+) or CD4(+)CD25(+)FoxP3(+)CTLA-4(+) and parasite load. Finally, we demonstrate a suppressive effect of Treg cells in specific T cell proliferative responses of P. vivax infected subjects after antigen stimulation with Pv-AMA-1. Our findings indicate that malaria vivax infection lead to an increased number of activated Treg cells that are highly associated with parasite load, which probably exert an important contribution to the modulation of immune responses during P. vivax infection.

Pre and post-natal exposure to ambient level of air pollution impairs memory of rats: the role of oxidative stress

The aims of this study were to evaluate whether air pollution during pre-natal and post-natal phases change habituation and short-term discriminative memories and if oxidants are involved in this process. As secondary objectives, it was to evaluate if the change of filtered to nonfiltered environment could protect the cortex of rats against oxidative stress as well as to modify the behavior of these animals. Wistar, male rats were divided into four groups (n = 12/group): pre and post-natal exposure until adulthood to filtered air (FA); pre-natal period to nonfiltered air (NFA-FA); until (21st post-natal day) and post-natal to filtered air until adulthood (PND21); prenatal to filtered air until PND21 and post-natal to nonfiltered air until adulthood (FA-NFA); pre and post-natal to nonfiltered air (NFA). After 150 days of air pollution exposure, animals were tested in the spontaneous object recognition test to evaluate short-term discriminative and habituation memories. Rats were euthanized; blood was collected for metal determination; cortex dissected for oxidative stress evaluation. There was a significant increase in malondialdehyde (MDA) levels in the NFA group when compared to other groups (FA: 1.730 +/- 0.217; NFA-FA: 1.101 +/- 0.217; FA-NFA: 1.014 +/- 0.300; NFA: 5.978 +/- 1.920 nmol MDA/mg total proteins; p = 0.007). NFA group presented a significant decrease in short-term discriminative (FA: 0.603 +/- 0.106; NFA-FA: 0.669 +/- 0.0666; FA-NFA: 0.374 +/- 0.178; NFA: -0.00631 +/- 0.106 sec; p = 0.006) and an improvement in habituation memories when compared to other groups. Therefore, exposure to air pollution during both those periods impairs short-term discriminative memory and cortical oxidative stress may mediate this process.

High level of aspartic acid-bond isomerization during the synthesis of an N-linked tau glycopeptide

An increased degree of utilization of the potential N-glycosylation site In the fourth repeat unit of the human tau protein may be involved in the inability of tau to bind to the corresponding tubulin sequence(s) and in the subsequent development of the paired helical filaments of Alzheimer's disease. To model these processes, we synthesized the octadecapeptide spanning this region without sugar, and with the addition of an N-acetyl-glucosamine moiety. The carbohydrate-protected, glycosylated asparagine was incorporated as a building block during conventional Fmoc-solid phase peptide synthesis. While the crude non-glycosylated analog was obtained as a single peptide, two peptides with, the identical, expected masses, in approximately equal amounts, were detected after the cleavage of the peracetylated glycopeptide. Surprisingly, the two glycopeptides switched positions on the reversed-phase high performance liquid chromatogram after removal of the sugar-protecting acetyl groups. Nuclear magnetic resonance spectroscopy and peptide sequencing identified the more hydrophobic deprotected peak as the target peptide, and the more hydrophilic deprotected peak as a peptide analog in which the aspartic acid-bond just preceding the glycosylated asparagine residue was isomerized resulting in the formation of a beta-peptide. The anomalous chromatographic behavior of the acetylated beta-isomer could be explained on the basis of the generation of an extended hydrophobic surface which is not present in any of the other three glycopeptide variants. Repetition of the syntheses, with altered conditions and reagents, revealed reproducibly high levels of aspartic acid-bond isomerization of the glycopeptide as well as lack of isomerization for the non-glycosylated parent analog. If similar increased aspartic acid-bond isomerization occurs in vivo, a protein modification well known to take place for both the amyloid deposits and the neurofibrillary tangles in Alzheimer's disease, this process may explain the aggregation of glycosylated tau into the paired helical filaments in the affected brains. Copyright (C) 1999 European Peptide Society and John Wiley & Sons, Ltd.