Chordomas at High Prevalence in the Captive Population of the Endangered Perdido Key Beach Mouse (Peromyscus polionotus trissyllepsis).

The Perdido Key beach mouse (Peromyscus polionotus trissyllepsis) is a critically endangered subspecies of the oldfield mouse. The captive population, currently maintained by 3 Florida zoos, is entirely derived from just 3 wild-caught ancestor mice. Necropsy and histopathology revealed chordoma of the vertebral column in 38 of 88 (43%) mice. The tumors were locally expansile and invasive masses of large physaliferous (vacuolated) cells with small, round, hyperchromatic nuclei, similar to the "classic" form of chordomas described in humans. Primary tumors rarely contained small amounts of bone and cartilaginous matrix, characteristic of the "chondroid" form. Neoplastic cells contained abundant granules positive by the periodic acid-Schiff reaction. Brachyury and cytokeratin AE1/AE3 were detected in neoplastic cells by immunohistochemistry, but uncoupling protein 1 was not identified. Primary tumors occurred along the entire vertebral column--cervical, 5 of 38 (13%); thoracic, 16 (42%); lumbar, 13 (34%); and sacral, 10 (26%)--and 10 (26%) mice had multiple primary masses. Metastases to the lungs were noted in 13 of the 38 (34%) mice. Mice diagnosed with chordomas postmortem ranged from 424 to 2170 days old, with a mean of 1399 days. The prevalence of chordoma was not significantly different between males (n = 23 of 50; 46%) and females (n = 15 of 38; 39%).

Pegylated feline granulocyte colony-stimulating factor increases neutrophil levels in cats.

Neutropenia can often be corrected by treatment with granulocyte-colony stimulating factor (G-CSF) and off-label use of commercial human G-CSF (HuG-CSF) is a commonly used treatment for neutropenic animals. However, long-term HuG-CSF treatment can be associated with adverse effects, including neutropenia. Here, feline (Fe) G-CSF was produced in Pichia pastoris, pegylated (Peg) FeG-CSF and tested in cats. A randomized controlled clinical trial was conducted to evaluate the efficacy of PegFeG-CSF compared to FeG-CSF or HuG-CSF in FIV-infected (n=14), FIV-uninfected healthy cats (n=19), and in HuG-CSF-induced neutropenic cats (n=4). Daily FeG-CSF doses induced higher neutrophil production than HuG-CSF after the second week of treatment (P ⩽ 0.002). Weekly doses of PegFeG-CSF induced higher neutrophil counts and showed greater sustained activity than weekly doses of FeG-CSF. PegFeG-CSF provided the most therapeutic and sustainable neutrophil production (P<0.001) in both FIV-uninfected and FIV-infected cats, without the development of neutralizing antibodies. Conversely, all HuG-CSF-treated cats developed neutralizing antibodies, suggesting cross-reactive antibodies to endogenous G-CSF in a majority of the cases with severe neutropenia. Strikingly, when PegFeG-CSF was used to rescue cats with HuG-CSF-induced neutropenia, clinically normal neutrophil numbers returned. Thus, PegFeG-CSF appears to be a superior treatment for neutropenia in feline patients.

Medical student rankings of proposed sanction for unprofessional behaviours relating to academic integrity: results from a Scottish medical school.

The General Medical Council emphasizes the cultivation of professional behaviours among medical students from early undergraduate years. Learning professional behaviours, however, is a progression and is constituted of several developmental stages. Behaving with academic integrity may be the first stage. In an educational setting, academic integrity is represented by a collection of diverse behaviours. Although there is consensus within the medical community that the absence of (or lapses in) academic integrity is unacceptable, the level of sanctions recommended for medical students is controversial. In the main, these punitive decisions over students are taken by teachers and clinicians. What sanctions would students suggest for a colleague who is academically unprofessional? This study reports the sanctions recommended by 375/700 (54%) of the students of one Scottish medical school in relation to lapses in academic integrity.

Validation of the Greek translation of the Dundee Ready Education Environment Measure (DREEM).

CONTEXT: The educational environment makes an important contribution to student learning. The DREEM questionnaire is a validated tool assessing the environment. OBJECTIVES: To translate and validate the DREEM into Greek. METHODS: Forward translations from English were produced by three independent Greek translators and then back translations by five independent bilingual translators. The Greek DREEM.v0 that was produced was administered to 831 undergraduate students from six Greek medical schools. Cronbach's alpha and test-retest correlation were used to evaluate reliability and factor analysis was used to assess validity. Questions that increased alpha if deleted and/or sorted unexpectedly in factor analysis were further checked through two focus groups. FINDINGS: Questionnaires were returned by 487 respondents (59%), who were representative of all surveyed students by gender but not by year of study or medical school. The instrument's overall alpha was 0.90, and for the learning, teachers, academic, atmosphere and social subscales the alphas were 0.79 (expected 0.69), 0.78 (0.67), 0.69 (0.60), 0.68 (0.69), 0.48 (0.57), respectively. In a subset of the whole sample, test and retest alphas were both 0.90, and mean item scores highly correlated (p<0.001). Factor analysis produced meaningful subscales but not always matching the original ones. Focus group evaluation revealed possible misunderstanding for questions 17, 25, 29 and 38, which were revised in the DREEM.Gr.v1. The group mean overall scale score was 107.7 (SD 20.2), with significant differences across medical schools (p<0.001). CONCLUSION: Alphas and test-retest correlation suggest the Greek translated and validated DREEM scale is a reliable tool for assessing the medical education environment and for informing policy. Factor analysis and focus group input suggest it is a valid tool. Reasonable school differences suggest the instrument's sensitivity.

Development and validation of an instrument to measure the postgraduate clinical learning and teaching educational environment for hospital-based junior doctors in the UK.

This paper describes the development and validation of a 40-item inventory, the Postgraduate Hospital Educational Environment Measure (PHEEM), by researchers in Scotland and the West Midlands using a combination of grounded theory and Delphi process. The instrument has since returned an alpha reliability >0.91 in two administrations in England and may be a useful instrument in the quality assurance process for postgraduate medical education and training.

Helping medical students to find their moral compasses: ethics teaching for second and third year undergraduates.

The paper describes a two week course that has been offered as a special study module to intermediate level (second and third year) undergraduate medical students at Dundee University Medical School for the past five years. The course requires students to research the various aspects of ethical dilemmas that they have identified themselves, and to "teach" these issues to their colleagues in a short PowerPoint presentation as well as to prepare an extended 3000 word essay discussion. The course specifically asks students not to disclose their own ethical positions, as these are probably still in formation and the objective is to promote critical thinking capacity in ethical and moral issues as a prelude to the development of practical skills in dealing with clinical problems. The course is easy to resource for the school and has received universally high evaluations from the students since its inception.

Under-ascertainment of multiple myeloma among participants in UK atmospheric atomic and nuclear weapons tests.

An inter-comparison of cases of multiple myeloma among UK participants in the UK's atmospheric atomic and nuclear weapons tests ascertained by direct follow up methods detected at least a third more cases than a strategy relying solely on data linkage between the Office of National Statistics and the Service Records Offices. These finding have implications for the conduct and robustness of follow up studies of long term health effects among participants in nuclear weapons tests.

Students' perspectives on the educational environment, Faculty of Medical Sciences, Trinidad

The Dundee Ready Education Environment Measure (DREEM) was administered to 70 final-year medical students and 36 first-year medical interns (pre-registration house officers). The overall total mean DREEM scores for the five subscales--namely, students' perceptions of the atmosphere, students' perceptions of learning, students' social self-perceptions, students' perceptions of teachers and students' academic self-perceptions--was 109.9 and the total mean scores for the subgroups--male students, male interns, female students and female interns--were 103.39, 111.82, 111.33 and 113.15, respectively. The lowest scores were assigned to students' social self-perceptions and students' perceptions of the atmosphere. All of the participants except the male interns recorded the highest scores for the subscale academic self-perceptions.

Congenic C57BL/6 mu opiate receptor (MOR) knockout mice: baseline and opiate effects.

Homozygous mu-opioid receptor (MOR) knockout (KO) mice developed on a chimeric C57B6/129SV background lack morphine-induced antinociception, locomotion and reward. Therefore it appears that MOR largely mediates these morphine actions. However, one factor that could affect the extent of knockout deficits in morphine-induced behavior is the genetic background against which the gene deletion is expressed. To examine the effect of genetic background chimeric C57B6/129SV MOR knockout mice from the 15th generation of those developed in our laboratory were backcrossed for 10 successive generations with C57BL/6 mice, a strain which is more sensitive to many of the properties of morphine, to produce congenic MOR (con-MOR) KO mice. Heterozygote conMOR KO mice display attenuated morphine locomotion and reduced morphine analgesia compared to wild-type mice. Homozygote con-MOR KO mice display baseline hyperalgesia, no morphine place preference, no morphine analgesia and no morphine locomotion. These results are not qualitatively different from those observed in the MOR KO strain with a chimeric C57B6/129SV background, and suggest that although the strain has separate influences on these functions, it does not substantially interact with deletion of the mu opiate receptor gene.

Analyzing end-of-life care legislation: a social work perspective.

Several policy approaches are currently being considered in an attempt to organize a national response to the crisis surrounding quality end-of-life care. Recent healthcare efforts aimed at supporting individuals facing advanced illness are marked by debate over assisted suicide, untimely referrals to hospice care, inconsistent adherence to advance directives, and substantive amounts of unrelieved pain in end-of-life. Social workers require a clear understanding of the current political and social climate if they are to navigate the ethical dilemmas as they are presented in end-of-life care. This article discusses recently proposed policy responses to the various political and social controversies surrounding end-of-life care for individuals facing advanced illness. The analysis will suggest criteria for evaluating end-of-life policy in general and offer a framework for evaluating proposed legislation. Suggestions for making end-of-life policy more effective and areas for future research will be proposed. Finally, the implications of this policy analysis for social work will be delineated.

Sitting it out in the sealed room: the Israeli response in the 1991 Gulf War.

The response of the Israeli civilian population to the Scud missile attacks and the possibility of chemical and biological warfare during the 1991 Gulf War have been monitored in various contexts. The present article reviews the findings and their implications for civilian defence planning in the event of a reprise. In 1991 the most controversial policy was the insistence that Israeli families prepare a sealed room in which to sit out the Iraqi attacks. The evidence suggests that in some instances this may have been counterproductive, even during relatively short periods of immurement.

Human radiation experiments: what price informed consent?

In 1992 a system of public access was established to more than three million pages of files in government depositories related to radiation experiments on US citizens, including children, pregnant women, and convicts, studying the effects of radioactive isotopes and testicular irradiation. The background to some of these studies is described; many were considered by Ethics Committees and the results published in the open literature after peer review.

Living with rattlesnakes: Chernobyl and Dounreay.

After the Three Mile Island nuclear plant accident in 1979, a local Pennsylvania resident told The New York Times 'You live with that plant over there for years and years and don't think much about it. But it's like living with a rattlesnake. Sooner or later it's going to bite you. You just don't know when.' As we enter the twenty-first century, many communities find themselves living with rattlesnakes--one at least of which has already bitten. This article considers the official responses to Chernobyl in the first decade after the accident and compares them to the statements surrounding the sudden 1998 decision to decommission the nuclear reprocessing plant at Dounreay in Scotland.

Mortality and morbidity of members of the British Nuclear Tests Veterans Association and the New Zealand Nuclear Tests Veterans Association and their families.

More than 20,000 British servicemen--many of them on their National Service, few of them volunteering for the tests, and most in their early twenties, some still boy soldiers in their teens--were required to 'participate' in the United Kingdom nuclear tests in Australia and Christmas Island in the 1950s and 1960s. 528 members of the New Zealand Navy were also present for one series of tests. There was also a Fijian Army contingent, which has been variously numbered between 100 and 500 men. An estimated 16,000 Australian servicemen and civilians were also involved in the tests at Maralinga and other sites. The men performed a wide range of duties, from highly technical preparations for the detonations to catering and clerical jobs. But whatever their role, they were all required to witness the detonations as part of their 'indoctrination' for the possibility of nuclear war. Most of them were required to line up on the beach, with their backs to the detonations and their hands over their eyes for the first minute or so. They were then allowed to turn around and look at the awesome sight as the mushroom cloud plumed thousands of feet into the air. Very few wore more than shorts and sandals during their time at the tests; only those who were thought to be at risk from radiation injury were issued with protective clothing and radiation dose badges. The UK government was sure that the troops, most of whom were standing within 20 km of the detonations and some of whom were present for 25 nuclear bomb blasts in as many weeks on Christmas Island, were not irradiated. The Ministry of Defence still routinely issues a document to nuclear veterans who feel that their illnesses were caused by the radiation they encountered when they were young men which states: The background [radiation] dose received by civilians and members of HM Forces serving at or off Christmas Island in the years 1956 to 1964 was only about 35% of that which they would have received on average had they remained, for that period of their lives, in the United Kingdom--that is, some 100 microsieverts per calendar month less at Christmas Island than in the United Kingdom. This sanguine view of the health burden borne by nuclear veterans and their families is not borne out by the data reported in this study of the health outcomes of the 2,500 men (2,200 UK, 238 New Zealand and 62 Fijian) on whom data are available to the present researcher. Thirty per cent of the men in this sample have already died, mostly in their fifties. Two-thirds of them died from cancers that are pensionable in the United States as presumptively radiogenic among nuclear veterans. About one in seven of the men in the sample of 1,014 who responded to the questionnaire circulated in late 1997 did not father any children after they returned from the weapons tests. Among the nearly 5,000 children and grandchildren of this group of more than a thousand veterans, there are 26 cases of spina bifida alone--more than five times the usual rate for live births in the UK. Nearly half the health problems among the offspring of the nuclear weapons tests veterans reported in this study consist of the same dermatological, musculoskeletal and gastrointestinal conditions from which many of the men have also suffered. Among the 2,261 children of 1,041 veterans, more than 200 skeletal abnormalities were reported, including more than 30 cases of short stature and 18 spinal problems, mostly curvature and scoliosis. More than 100 skin conditions were reported, mostly eczema and dermatitis, in many cases described as congenital. Over 50 of the children are already suffering from arthritis and similar conditions, although they are only now entering their thirties. Hip deformities were reported for 19 children and kneecap deformities for 14. More than 100 of the veterans' children reported reproductive difficulties; 24 women reported problems with their ovaries. This pattern of morbidity was repeated in the grandchildren, tho

The glass bead game: nuclear tourism at the Australian weapon test sites.

In mid-summer 1997, just as the United States National Cancer Institute was acknowledging that the nuclear bomb tests at the Nevada Test Site may ultimately cause up to 75,000 cases of thyroid cancer in people who were living in the USA in the 1950s and 1960s, the Australian authorities were mooting the possibility that the Maralinga test sites in South Australia should become a tourist attraction. Some Aboriginal tribal leaders welcomed this proposed use when the 20 million Pounds 'clean-up' being paid for by the United Kingdom government as some compensation for using the area for its weapons tests in the 1950s and 1960s is completed. This paper surveys the attempts to clean up the site of UK nuclear weapons tests in the 1950s, not least by attempting to vitrify vast tracts of desert.

Puff the magic dragon: how our understanding of fallout, residual and induced radiation evolved over fifty years of nuclear weapons testing.

Radiobiological science has proceeded on empirical principles since health physics became a necessary professional adjunct to the military and civilian uses of nuclear energy in the aftermath of the detonations at Hiroshima and Nagasaki. This paper reviews the data which gradually emerged indicating that early assumptions about the detonation of atomic and nuclear weapons underestimated the significance of fallout, residual and induced radiation as health hazards. Many of these assumptions are being examined in three test cases concerning veterans of United Kingdom atomic and nuclear weapons tests heard by the European Court of Human Rights in November 1997.