The Petal Project: An innovation in sexual healthcare and education for Kenyan schoolgirl.

In the western province of Nyanza in Kenya, girls and women face an issue all too common in the developing world-little or no access to affordable means to effectively managing their menstrual flow. As a result, many stay at home or drop out of school because they are teased and embarrassed. Some approach men for money to buy pads and are forced, in return, to engage in transactional sex. The girls may not be able to return to school at all due to pregnancy. The story literally and figuratively continues to cycle, keeping girls in positions of dependency and poverty. In May 2011, two visiting nursing faculty conducting health clinics with students, were approached by a young male school volunteer who shared his observations and unease with what he saw happening. Concerns shared that day spawned an initiative known as the Petal Project, which has yielded thousands of starter kits hand-sewn and delivered to girls in Kenya. The Petal Project has grown in popularity and participation on their college campus and in neighboring communities. Since its inception, this initiative has expanded to include over six countries and has positively impacted the lives of hundreds of givers and receivers.

Creating a Nurse-Led Culture to Minimize Horizontal Violence in the Acute Care Setting: A Multi-Interventional Approach.

Horizontal violence (HV) is prevalent in nursing. However, few strategies are identified to address this phenomenon that undermines communication and patient safety. Nurses at an acute care hospital implemented multiple interventions to address HV resulting in increased knowledge of hospital policies regarding HV, and significantly (p < .05) less HV prevalence than was reported by nurses in other organizations throughout New York State. With the aid and oversight of nursing professional development specialists, evidence-based interventions to address HV were developed including policies, behavioral performance reviews, and staff/manager educational programs.

Assessment and planning for a dedicated education unit.

This pilot project describes the use of the Revised Professional Practice Environment scale to identify inpatient acute care units suitable for implementation of dedicated education units. Staff development professionals may use the suggested model to assess and plan phases of a dedicated education unit.

The role of histamine degradation gene polymorphisms in moderating the effects of food additives on children's ADHD symptoms.

OBJECTIVE: Food additives can exacerbate ADHD symptoms and cause non-immunoglobulin E-dependent histamine release from circulating basophils. However, children vary in the extent to which their ADHD symptoms are exacerbated by the ingestion of food additives. The authors hypothesized that genetic polymorphisms affecting histamine degradation would explain the diversity of responses to additives. METHOD: In a double-blind, placebo-controlled crossover trial, challenges involving two food color additive and sodium benzoate (preservative) mixtures in a fruit drink were administered to a general community sample of 3-year-old children (N = 153) and 8/9-year-old children (N = 144). An aggregate ADHD symptom measure (based on teacher and parent blind ratings of behavior, blind direct observation of behavior in the classroom, and--for 8/9-year-old children only--a computerized measure of attention) was the main outcome variable. RESULTS: The adverse effect of food additives on ADHD symptoms was moderated by histamine degradation gene polymorphisms HNMT T939C and HNMT Thr105Ile in 3- and 8/9-year-old children and by a DAT1 polymorphism (short versus long) in 8/9-year-old children only. There was no evidence that polymorphisms in catecholamine genes COMT Val108Met, ADRA2A C1291G, and DRD4-rs7403703 moderated the effect on ADHD symptoms. CONCLUSIONS: Histamine may mediate the effects of food additives on ADHD symptoms, and variations in genes influencing the action of histamine may explain the inconsistency between previous studies. Genes influencing a range of neurotransmitter systems and their interplay with environmental factors, such as diet, need to be examined to understand genetic influences on ADHD symptoms.

Short telomeres in short-lived males: what are the molecular and evolutionary causes?

Telomere length regulation is an important aspect of cell maintenance in eukaryotes, since shortened telomeres can lead to a number of defects, including impaired cell division. Although telomere length is correlated with lifespan in some bird species, its possible role in aging and lifespan determination is still poorly understood. Here we investigate telomere dynamics (changes in telomere length and attrition rate) and telomerase activity in the ant Lasius niger, a species in which different groups of individuals have evolved extraordinarily different lifespans. We found that somatic tissues of the short-lived males had dramatically shorter telomeres than those of the much longer-lived queens and workers. These differences were established early during larval development, most likely through faster telomere shortening in males compared with females. Workers did not, however, have shorter telomeres than the longer-lived queens. We discuss various molecular mechanisms that are likely to cause the observed sex-specific telomere dynamics in ants, including cell division, oxidative stress and telomerase activity. In addition, we discuss the evolutionary causes of such patterns in ants and in other species.

Differential gene expression between adult queens and workers in the ant Lasius niger.

Ants and other social insects forming large societies are generally characterized by marked reproductive division of labour. Queens largely monopolize reproduction whereas workers have little reproductive potential. In addition, some social insect species show tremendous lifespan differences between the queen and worker caste. Remarkably, queens and workers are usually genotypically identical, meaning that any phenotypic differences between the two castes arise from caste-specific gene expression. Using a combination of differential display, microarrays and reverse Northern blots, we found 16 genes that were differentially expressed between adult queens and workers in the ant Lasius niger, a species with highly pronounced reproductive division of labour and a several-fold lifespan difference between queens and workers. RNA ligase mediated rapid amplification of cDNA ends (RLM-RACE) and gene walking were used to further characterize these genes. On the basis of the molecular function of their nearest homologues, three genes appear to be involved in reproductive division of labour. Another three genes, which were exclusively overexpressed in queens, are possibly involved in the maintenance and repair of the soma, a candidate mechanism for lifespan determination. In-depth functional analyses of these genes are now needed to reveal their exact role.

Reduced 6-month resource use and costs associated with cilostazol in patients after successful coronary stent implantation: results from the Cilostazol for RESTenosis (CREST) trial.

BACKGROUND: The CREST trial demonstrated that after successful coronary stent implantation, the 6-month rate of target vessel revascularization (TVR) was similar (15.4% vs 16%, P = .90) for the 2 treatment groups, but restenosis rate was lower (22.0% vs 34.5%, P = .002) in cilostazol-treated patients. We sought to evaluate resource use, cost, and cost-effectiveness of cilostazol in CREST. METHODS: A total of 705 patients were randomized to cilostazol 100 mg twice daily (n = 354) versus placebo (n = 351) for 6 months. Resources included rehospitalizations, medications, and outpatient services. Costs were determined from the Medicare fee schedule. Cilostazol was priced at 1.64 dollars a day. Base-case cost and cost-effectiveness analysis was performed for the entire population using TVR as a measure of effectiveness. Sensitivity analysis was conducted among 526 patients because restenosis data were available only for this patient population. A bootstrap resample approach (5000 samples) was used to obtain confidence intervals for cost differences. RESULTS: For the entire population, costs of rehospitalizations, concomitant medications, outpatient tests, and physician or emergency department visits were lower during follow-up for cilostazol-treated patients. Overall, total 6-month follow-up costs remained 447 dollars lower for cilostazol (4178 dollars vs 4625 dollars), although this difference did not reach significance (95% CI -1458 dollars to 515 dollars). Cilostazol is likely a cost-saving strategy (similar rate of TVR and lower costs). Sensitivity analysis showed that cilostazol is likely a dominant strategy (lower restenosis rate and costs, 85% dominant, 88.9% <1000 dollars per restenosis averted). CONCLUSIONS: Treatment with cilostazol is likely a cost-saving or dominant strategy in patients with successful coronary bare metal stent implantation. Cilostazol may offer a low-cost alternative to restenosis prevention in patients who do not receive drug-eluting stents.

Decreased expression of Cu-Zn superoxide dismutase 1 in ants with extreme lifespan.

Reactive oxygen species, the by-products of oxidative energy metabolism, are considered a main proximate cause of aging. Accordingly, overexpression of the enzyme Cu-Zn superoxide dismutase 1 (SOD1) can lengthen lifespan of Drosophila melanogaster in the laboratory. However, the role of SOD1 as a main determinant of lifespan has been challenged on the grounds that overexpression might be effective only in compromised genetic backgrounds. Moreover, interspecific comparisons show lower levels of antioxidant activities in longer-lived species, suggesting that life-span extension may evolve through less reactive oxygen species generation from the mitochondria rather than higher expression of SOD1. The tremendous variation in lifespan between ant castes, ranging over 2 orders of magnitude, coupled with the fact that all individuals share the same genome, provides a system to investigate the role of SOD1 in the wild. We used the ant Lasius niger as a model system, because queens can reach the extreme age of 28 years, whereas workers and males live only 1-2 years and a few weeks, respectively. We cloned SOD1 and found that long-lived queens have a lower level of expression than workers and males. Specific enzyme-activity assays also showed higher SOD1 activity levels in males and workers compared with queens, which had SOD1 activity levels similar to that of D. melanogaster. Altogether, these data show that increased expression of SOD1 is not required for the evolution of extreme lifespan, even in a system in which differential gene expression is the only way to express phenotypes with great lifespan differences.

MHC VARIATION IN THE ENDANGERED GILA TOPMINNOW.

Sequence variation at a major histocompatibility complex (MHC) gene, assumed to be involved in parasite and pathogen resistance, was examined in the endangered Gila topminnow (Poeciliopis o. occidentalis), from the four watersheds where they remain in the United States. This is the first estimate of variation in MHC genes in natural populations of an endangered species. The population that has experienced the most bottlenecks historically was monomorphic for MHC variation. Another population, which earlier had been found to be the only population polymorphic for allozymes, had five MHC alleles, four different from those found in the other populations. Overall, nine different alleles were found. The four populations were highly divergent at MHC with four of the six population pairs not sharing any alleles. However, the magnitude of differentiation between populations on the amino-acid level varied fivefold for the populations that shared no alleles. Using single-stranded conformational polymorphism (SSCP), these alleles segregated consistently with Mendelian expectations in families. Because of the high genetic differentiation between these populations for a potentially adaptive gene, we recommend that the four watersheds be examined further for separate conservation and management.