Experiences of patients, parents, and healthcare professionals in the process of transitioning from hospital to community after inpatient pediatric rehabilitation among children with special health care needs.

PURPOSE: Children with Special Health Care Needs (CSHCN) may experience disruptions in education due to extended hospitalizations. The purpose of this study was to describe how CSHCN experience educational supports during inpatient rehabilitation and identify the ongoing challenges when planning to return to school. MATERIALS AND METHODS: Semi-structured focus groups were conducted with parents (n = 12), former patients (n = 20), and rehabilitation professionals (n = 8). RESULTS: Through qualitative thematic analysis based on descriptive phenomenology, we developed three themes: 1) Inpatient educational support such as instruction and schoolwork helped reduce the learning loss during hospitalization. However, these supports were sometimes complicated by lags in school approvals and challenges in coordination between systems. 2) Transition planning involved establishing necessary services to support CSHCN's educational and healthcare needs at school re-entry. However, families reported limited information and guidance as key barriers. 3) Dynamic courses of school re-entry required continued support after discharge. The participants recommended that reassessment and adjustment of transition plans were often necessary to account for evolving developmental and educational needs but were not always received. CONCLUSIONS: There is an ongoing need to improve communication between clinicians and educators, information for families, and long-term follow-up on the changing educational needs for CSHCN after rehabilitation.

School re-entry after extended hospitalization is challenging for children with special health care needs (CSHCN) due to school disruption, social disconnection, and change in functional abilities.The hospital-to-school transition processes include inpatient educational programs during hospitalization, pre-discharge transition planning, and the subsequent implementation and adjustment of transition plans to facilitate individualized school re-entry.Key areas in need of improving school re-entry include coordination between the hospital and school about rehabilitation and educational goals and information provided to families about transition processes, particularly for newly acquired health conditions.A common need expressed by parents and CSHCN is to simplify and accelerate the process to establish services that support children's educational and healthcare needs.

Quorum sensing modulates bacterial virulence and colonization dynamics of the gastrointestinal pathogen Citrobacter rodentium.

Quorum Sensing (QS) is a form of cell-to-cell communication that enables bacteria to modify behavior according to their population density. While QS has been proposed as a potential intervention against pathogen infection, QS-mediated communication within the mammalian digestive tract remains understudied. Using an LC-MS/MS approach, we discovered that Citrobacter rodentium, a natural murine pathogen used to model human infection by pathogenic Escherichia coli, utilizes the CroIR system to produce three QS-molecules. We then profiled their accumulation both in vitro and across different gastrointestinal sites over the course of infection. Importantly, we found that in the absence of QS capabilities the virulence of C. rodentium is enhanced. This highlights the role of QS as an effective mechanism to regulate virulence according to the pathogen's spatio-temporal context to optimize colonization and transmission success. These results also demonstrate that inhibiting QS may not always be an effective strategy for the control of virulence.

Gender Differences in a Risk-Reduction Model of Sharing.

The current experimental study investigated human sharing within a laboratory task that modeled environmental variability. In particular, it sought to assess the efficacy of a risk-reduction model of sharing, which originated from a risk-sensitive optimization model known as the energy-budget rule. Participants were given the choice between working alone or cooperating and sharing accumulated hypothetical earnings with a fictious partner. Failure to acquire sufficient money resulted in a loss of accumulated earnings. To investigate the effects of economic context on sharing, the difficulty of meeting an earnings requirement was manipulated across conditions by changing the monetary requirement that needed to be met in order to bank earnings, which could later be exchanged for real money. In some conditions sharing was the optimal strategy (positive budget conditions), sometimes working alone was optimal (negative budget conditions), and other times neither option was optimal (neutral budget conditions). Gender differences were examined within this context to determine if males and females differed in their sharing behavior. The results suggested that males chose the sharing option more often in the positive budget condition and showed a stronger preference for the work-alone option in the negative budget condition than females.

Interteaching: How much does each component increase its efficacy?

Although interteaching has been shown to improve students' understanding of course material in a multitude of classroom studies, only one laboratory study investigating it has been published. In that study, interteaching led to significantly higher scores on a quiz compared to other teaching methods. The goal of the present study was to add to the laboratory literature in this area by determining which components of interteaching are important for students' academic success. A pretest/posttest design was used in which participants were randomly assigned to experience 1 of 4 conditions: 1) reading; 2) reading plus prep guide; 3) reading, prep guide, plus group discussion; or 4) reading, prep guide, group discussion, plus clarifying lecture. The results demonstrated that condition 3 produced the highest improvement in test scores, implying that the group discussion was integral to producing positive academic outcomes.

The effects of tributyrin supplementation on weight gain and intestinal gene expression in broiler chickens during Eimeria maxima-induced coccidiosis.

Butyrate is a feed additive that has been shown to have antibacterial properties and improve gut health in broilers. Here, we examined the performance and gene expression changes in the ileum of tributyrin-supplemented broilers infected with coccidia. Ninety-six, Ross 708 broilers were fed either a control corn-soybean-based diet (-BE) or a diet supplemented with 0.25% (w/w) tributyrin (+BE). Birds were further divided into groups that were inoculated with Eimeria maxima oocysts (EM) or sham-inoculated (C) on day 21 posthatch. At 7 d postinfection (7 d PI), the peak of pathology in E. maxima infection, tributyrin-supplemented birds had significantly improved feed conversion ratios (FCR, P < 0.05) and body weight gain (BWG, P < 0.05) compared with -BE-infected birds, despite both groups having similar feed intake (FI, P > 0.05). However, at 10 d post-infection (10 d PI) no significant effects of feed type or infection were observed. Gene expression in the ileum was examined for insights into possible effects of infection and tributyrin supplementation on genes encoding proteins related to immunity, digestion, and gut barrier integrity. Among immune-related genes examined, IL-1B and LEAP2 were only significantly affected at 7 d PI. Transcription of genes related to digestion (APN, MCT1, FABP2, and MUC2) were primarily influenced by infection at 7 d PI and tributyrin supplementation (FABP2 and MUC2) at 10 d PI. With exception of ZO1, tight junction genes were affected by either infection or feed type at 7 d PI. At 10 d PI, only CLDN1 was not affected by either infection or feed type. Overall tributyrin shows promise as a supplement to improve performance during coccidiosis in broiler chickens; however, its effect on gene expression and mode of action requires further research.

An investigation of the probability of reciprocation in a risk-reduction model of sharing.

A laboratory study investigated whether reductions in the probability of reciprocation would influence sharing in situations of shortfall risk. Choice in twelve adults was evaluated against the predictions of a risk-reduction model of sharing derived from a risk-sensitive foraging theory (the energy-budget rule). Participants responded on a computer task to earn hypothetical money which could be later exchanged for real money. If participants selected the sharing option, their earnings were pooled and split with a (fictitious) partner. To model shortfall risk, the task was arranged so that participants lost their accumulated earnings if it fell below an earnings requirement. Across conditions the probability that the partner would contribute to the pool was .95, .65, and 0. Choosing the sharing option was optimal under the .95 and .65, but not 0 condition. Although levels of preference for the sharing option were below optimal, participants chose it significantly more in the .95 and .65 conditions than in the 0 condition. Sharing was lower in the .65 condition than .95 condition but the difference was not statically significant. The results are consistent with prior cooperation research and demonstrate that under shortfall risk, reductions in the probability of reciprocation by partners may decrease sharing.

The prevalence of Helicobacter pylori antibody in different age groups in Central Texas.

OBJECTIVE: The prevalence of exposure to the bacteria Helicobacter pylori in Central Texas is unknown. It has been shown that elderly individuals have a higher rate of infection than younger individuals. Exposure is even higher in the elderly living in long term care facilities. Evidence of exposure can be demonstrated by the presence of antibody to H. pylori. Plasma samples collected from several age groups are tested for the antibody to determine the exposure rate for different age groups. DESIGN: An exemption was granted by the Texas State University Institutional Review Board (IRB) as the plasma samples had been previously collected for other types of laboratory assessments. Samples were tested with the Status H. pylori Immunoassay that identifies anti-H. pylori IgG antibody in plasma samples. SETTING: The research study took place in the Texas State University Clinical Laboratory Science Department. PATIENTS OR OTHER PARTICIPANTS: Blinded in-patient plasma samples were used that had been previously collected for other assays. MAIN SOURCE MEASURE(S): The percentage of positive antibody tests is determined by age group. RESULTS: The chi-squared (chi2) results for each age group expressed a p-value of 0.000. The age group, 41-60, had the highest rate of positive antibody tests at 24%. The second highest age group was the 61 and over age group at 17%. Third highest age group was the 21-40 age group at 16% positive tests. The lowest percentage testing positive was the 0-20 age group at 6%. CONCLUSION: There was a higher prevalence of antibody in patients older than 40 years old than in younger patients. Curiously, the oldest age group (61 years or older) did not have the highest rates of exposure. Exposure rates were much lower than rates seen in other areas.

Nuclear disconnection within the amygdala reveals a direct pathway to fear.

It is widely believed that a descending serial circuit consisting of neural projections from the basolateral complex (BLA) to the central nucleus (CEA) of the amygdala mediates fear expression. Here we directly test this hypothesis and show that disconnecting the BLA and CEA with asymmetric neurotoxic lesions after Pavlovian fear conditioning in rats completely abolishes the expression of conditional freezing. These results demonstrate that neural projections from the BLA to CEA are essential for the expression of learned fear responses.