Environmental enrichment models a naturalistic form of maternal separation and shapes the anxiety response patterns of offspring.

Environmental enrichment (EE) mimics positive life experiences by providing enhanced social and physical stimulation. Placement into EE following weaning, or in later life, confers beneficial outcomes on both emotional and cognitive processes. However, anxiety-like behavior is also reported, particularly in rats exposed to enhanced housing during early development. Notably, the quality of maternal behavior affects stress regulation and emotional stability in offspring, yet the impact of environmental context on maternal care has not been thoroughly evaluated, or are the influences of EE on their offspring understood. To investigate the role of EE on these factors we analyzed the details of mother-neonate interactions, and juvenile offspring performance on several anxiety measures. Additionally, we evaluated neurochemical differences (i.e. serotonin, corticosterone, GABA, glutamate) in prefrontal cortex and hippocampus as a function of EE, Communal Nesting (CN) and Standard Care (SC). Although EE dams spent significantly less time on the nest and had lower nursing frequencies compared to SC dams, there were no differences in maternal licking/grooming. In offspring, EE increased GLUR1 level and GABA concentrations in the prefrontal cortex of both juvenile male and female rats. A similar pattern for glutamate was only observed in males. Although EE offspring spent less time on the open arms of the elevated plus maze and had faster escape latencies in a light-dark test, there were no other indications of anxiety-like behavior on these measures or when engaged in social interaction with a conspecific. In the wild, rats live in complicated and variable environments. Consequently dams must leave their nest to defend and forage, limiting their duration of direct contact. EE exposure in early development may mimic this naturalistic maternal separation, shaping parental behavior and offspring resiliency to stressors.

Environmental enrichment mitigates the sex-specific effects of gestational inflammation on social engagement and the hypothalamic pituitary adrenal axis-feedback system.

Modest environmental enrichment (EE) is well recognized to protect and rescue the brain from the consequences of a variety of insults. Although animal models of maternal immune activation (MIA) are associated with several neurodevelopmental impairments in both the behavioral and cognitive functioning of offspring, the impact of EE in protecting or reversing these effects has not been fully evaluated. In the present study, female Sprague-Dawley rats were randomized into EE (pair-housed in a large multi-level cage with toys, tubes and ramps) or animal care control (ACC; pair-housed in standard cages) conditions. Each pair was bred, following assignment to their housing condition, and administered 100µg/kg of lipopolysaccharide (LPS) on gestational day 11. After birth, and until the end of the study, offspring were maintained in their respective housing conditions. EE protected against both the social and hypothalamic pituitary adrenal axis consequences of MIA in juvenile male rats, but surprisingly not against the spatial discrimination deficits or accompanying decrease in glutamate levels within the hippocampus (as measured via LCMS-MS). Based on these preliminary results, the mechanisms that underlie the sex-specific consequences that follow MIA appear to be dependent on environmental context. Together, this work highlights the importance of environmental complexity in the prevention of neurodevelopmental deficits following MIA.

Arranged marriages, unlikely partners. How will their offspring look?

In the new era of managed care, many religious healthcare providers are making "arranged marriages"--permanent partnerships with secular organizations. As they do so, the religious partners naturally ponder how best to ensure that their values permeate the new entity and thus prevail in later organizational "offspring." The organizations most likely to perpetuate their values are those with ethical corporate cultures and climates. These include religiously based healthcare providers, but such providers seem to lack confidence today in their ability to maintain culture and climate in newly formed partnerships. That may be fortunate because it prevents them from trying to impose their values on secular partners. Nevertheless, such values are often attractive to a prospective partner. A religious healthcare provider will need market leverage, as well as attractive values, to make a good "marriage." Even so, religious providers and secular investor-owned organizations are unlikely partners, because their motives and incentives differ radically. But religious providers can form solid relationships with secular, not-for-profit healthcare organizations if they take care to negotiate a binding commitment to maintain an ethical culture and climate. However, Catholic providers are at a disadvantage in such negotiations because Catholic religious congregations are unlikely to continue as owner-sponsors much beyond another decade. It is crucial that a stable source of influence develop to ensure a religious presence in the offspring of new partnerships.

Health status of the community becoming focus of MHS (Mercy Health Services) system. Interview by Donald E.L. Johnson.

Since hospitals exist to stabilize and improve the health of the people they serve, they should form community health care systems that offer the full spectrum of services in an organized way, says Edward J. Connors, president of Mercy Health Services, in the following interview with Donald E.L. Johnson, editor and publisher of Health Care Strategic Management. Skills in epidemiology are desperately needed to accomplish this, as well as skills in statistics, information systems and outcomes measurement. Connors believes that a consensus has formed on the core content of health status measurement. Hospitals should start building the information base needed to improve the health status of their target population.

Catholic health care: future blueprint.

Every Catholic hospital is influenced by one of two models of behavior, the private-business model and the public-service model. Which model eventually dominates an organization's actions is determined by the behavior of its leaders--sponsors, trustees, executive managers, and physicians. Since these internal forces are more likely than are external forces to determine an organization's course, Catholic health care leaders must consciously decide which value they wish to embrace. They also must improve their ability to forecast and influence the future, beginning with the creation of an independent national commission formed to assess the status of Catholic health care. Religious institutes, seeking collaboration and dialogue among themselves, should play a key role in implementing such a commission's recommendations. The Catholic health care systems that emerge in the future as a result of long-range planning and a value-driven philosophy will be multicongregational rather than owned by a single religious institute, fewer in number and larger in scope, and influential on a regional level. They will be expected to participate in networking with local non-Catholic providers and to integrate finance and delivery.

The future of the pathologist in the hospital setting.

The future of the pathologist in the hospital setting can be speculated on in light of contemporary and predictable trends occurring in hospitals. From five of these trends--downsizing, restructuring, diversification, hospital-physician relations, and for-profit hospitals--eight implications for the practice of pathology are identified.