Effect of Geography and Captivity on Scat Bacterial Communities in the Imperiled Channel Island Fox.

With developing understanding that host-associated microbiota play significant roles in individual health and fitness, taking an interdisciplinary approach combining microbiome research with conservation science is increasingly favored. Here we establish the scat microbiome of the imperiled Channel Island fox (Urocyon littoralis) and examine the effects of geography and captivity on the variation in bacterial communities. Using high throughput 16S rRNA gene amplicon sequencing, we discovered distinct bacterial communities in each island fox subspecies. Weight, timing of the sample collection, and sex contributed to the geographic patterns. We uncovered significant taxonomic differences and an overall decrease in bacterial diversity in captive versus wild foxes. Understanding the drivers of microbial variation in this system provides a valuable lens through which to evaluate the health and conservation of these genetically depauperate foxes. The island-specific bacterial community baselines established in this study can make monitoring island fox health easier and understanding the implications of inter-island translocation clearer. The decrease in bacterial diversity within captive foxes could lead to losses in the functional services normally provided by commensal microbes and suggests that zoos and captive breeding programs would benefit from maintaining microbial diversity.

The Use of ß-Adrenergic Receptor Antagonists in Psychiatry: A Review.

BACKGROUND: ß-Blockers (BBs) are a widely used class of medications with a number of medical indications. Their ability to suppress the adrenergic response has made them a target of investigation for treating a variety of psychiatric symptoms. OBJECTIVE: The aim of this review is to identify evidence regarding the use of BBs for various psychiatric disorders including anxiety disorders, mood disorders, psychosis, and posttraumatic stress disorder. We also review the evidence for use for aggression and agitation and for extrapyramidal side effects of psychiatric medications. METHODS: A search of PubMed and Google Scholar was conducted with search terms relevant to the use of BBs for psychiatric conditions. Studies were selected based on relevance to the review objective, focusing on systematic reviews and meta-analyses. Case reports were included and are clearly identified when referenced in this review. RESULTS: A total of 44 publications were included that examined the use of BBs as treatment for the following psychiatric symptoms and conditions: anxiety disorders, depression and mood disorders, acute stress disorder and postraumatic stress disorder, psychotic disorders and extrapyramidal symptoms, as well as aggression and agitation. Additionally, adverse effects and drug-drug interactions were reviewed. CONCLUSION: Well-characterized psychiatric uses of BBs include treating symptoms of performance anxiety and akathisia. Some positive evidence exists for BB therapy in other disorders such as specific phobia, panic disorder, and for aggression in patients with psychosis, acquired brain injury, or intellectual disability. Most of the evidence on the role of BBs in psychiatry is as adjunctive treatment for management of somatic symptoms rather than as monotherapy. Outside of performance anxiety and akathisia, the role of BBs in psychiatry has not been subjected to careful study, and further investigative trials are needed.

Factors Affecting Psychiatry Resident Decision to Pursue Consultation-Liaison Psychiatry or Other Subspecialty Fellowship Training.

BACKGROUND: There is a national shortage of psychiatrists with subspecialty fellowship training, and many fellowship positions are unfilled. OBJECTIVE: We conducted a survey of US psychiatry residents to better understand the motivation to pursue fellowship training and to determine any specific factors that were particularly influential in choosing a fellowship in consultation-liaison (C-L) psychiatry. METHODS: Online surveys were distributed electronically to US general psychiatry residents through the American Association of Directors of Psychiatric Residency Training list server. RESULTS: A total of 219 questionnaires were completed. Interest in fellowship declined during residency training. Most important factors in consideration of fellowship training were lifestyle (89%), finances (69%), and academic opportunities (63%). Specific influential factors were residency experiences, attending staff as a role model, and medical school experiences. Most important discouraging factors were extra training time, financial concerns, and belief that fellowship training was not necessary. Only 30% of residents had outpatient C-L psychiatry experiences. Few residents belonged to any subspecialty organization or attended any subspecialty meeting. Residents interested in C-L psychiatry fellowships had lower expectation of increased salary than other residents. Outpatient practice settings were seen as preferable over inpatient settings by most residents. CONCLUSIONS: Results of this survey suggest that enhancing consultation psychiatry exposure in medical school and residency with strong role models, outpatient C-L psychiatry experiences, facilitating subspecialty organization membership and meeting attendance, emphasizing academic opportunities of fellowship training, and improving remuneration for fellowship-trained psychiatrists might be important factors that could improve recruitment into C-L psychiatry and other psychiatric fellowships.

The Art and Science of Learning, Teaching, and Delivering Feedback in Psychosomatic Medicine.

BACKGROUND: The teaching and learning of psychosomatic medicine has evolved with the better understanding of effective teaching methods and feedback delivery in medicine and psychiatry. OBJECTIVES: We sought to review the variety of teaching methods used in psychosomatic medicine, to present principles of adult learning (and how these theories can be applied to students of psychosomatic medicine), and to discuss the role of effective feedback delivery in the process of teaching and learning psychosomatic medicine. METHODS: In addition to drawing on the clinical and teaching experiences of the authors of the paper, we reviewed the literature on teaching methods, adult learning theories, and effective feedback delivery methods in medicine to draw parallels for psychosomatic medicine education. RESULTS: We provide a review of teaching methods that have been employed to teach psychosomatic medicine over the past few decades. We outline examples of educational methods using the affective, behavioral, and cognitive domains. We provide examples of learning styles together with the principles of adult learning theory and how they can be applied to psychosomatic medicine learners. We discuss barriers to feedback delivery and offer suggestions as to how to give feedback to trainees on a psychosomatic medicine service. CONCLUSIONS: The art of teaching psychosomatic medicine is dynamic and will continue to evolve with advances in the field. Psychosomatic medicine educators must familiarize themselves with learning domains, learning styles, and principles of adult learning in order to be impactful. Effective feedback delivery methods are critical to fostering a robust learning environment for psychosomatic medicine.