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Acquired cardiomyopathies have been described in human patients with hypoadrenocorticism. Several mechanisms have been described to explain the cardiac effects of primary adrenal insufficiency, but, clinically, these manifestations may be underappreciated in dogs. In humans, there is an infrequently described, reversible dilated cardiomyopathy in patients with hypoadrenocorticism. Two dogs were presented to a single referral center for evaluation of weakness or collapse and were subsequently diagnosed with hypoadrenocorticism after a full diagnostic workup. Following the diagnosis of hypoadrenocorticism and administration of glucocorticoids and desoxycorticosterone pivalate, both dogs developed left-sided congestive heart failure and had systolic dysfunction diagnosed by echocardiogram. Both dogs were euthanized; one because of recurrent congestive heart failure and another because of a concern for poor long-term prognosis and decreased quality of life. The purpose of this case report is to document multiple cases of hypoadrenocorticism-associated systolic dysfunction and subsequent cardiogenic pulmonary edema in dogs.

Smoking remains the leading cause of preventable death in the United States, with 87% of smokers starting before the age of 18. Age of initiation is a major predictive factor for smoking frequency and successful smoking cessation. People who initiate smoking during adolescences are 2.33 times more likely to become heavy smokers and half as likely to quit compared with smokers who started during adulthood. Additionally, schizophrenia, a disease state linked to altered neurodevelopment during adolescence, is a major predictive factor for smoking status. Smoking rates among people suffering from schizophrenia are between 60% and 90%. Interestingly, the Neuregulin Signalling Pathway (NSP), which plays an important role in neurodevelopment, is implicated in both schizophrenia and nicotine use disorder. Specifically, SNPS in neuregulin 3 (Nrg3) and Erb-B2 Receptor Tyrosine Kinase 4 (ErbB4) have been associated with smoking cessation outcomes and schizophrenia. Here, we examine the effects of chronic nicotine (18 mg/kg/day) and 24-h withdrawal on NSP gene expression in the hippocampus of adult (20-week-old) and adolescent (4-week-old) mice. We show that withdrawal from chronic nicotine decreased the expression of Erbb4 mRNA in the hippocampus of the adult mice but increased the expression of cytosolic Erbb4 protein in adolescent mice. Nrg3 mRNA and protein expression was not altered by chronic nicotine or withdrawal in the adult or adolescent cohorts, but Nrg3 mRNA and synaptosomal protein expression was lower in the adult withdrawal group when compared with their adolescent counterparts. These results highlight the age-specific effects of nicotine withdrawal on the NSP and may contribute to the lower quit rate and higher cigarette consumption of smokers who initiation during adolescences.

PurposeThis study centers the reflections of principals across the USA as they navigated the overwhelming stress of closing and reopening schools during a global pandemic. Specifically, the authors explored how school principals addressed self-care and their own well-being during the pandemic.Design/methodology/approachThis research study is part of a broader qualitative study conducted by 20 scholars from across the USA in Spring 2020 and organized by the Consortium for Policy Research in Education (CPRE). This national research team conducted 120 qualitative interviews with public school principals in 19 different states and 100 districts. As part of this team, the authors coded and analyzed all 120 transcripts in NVivo using a self-care framework.FindingsThe responses from the participants capture some of the complexity of self-care during the COVID-19 pandemic. The authors found evidence of both negative and positive sentiments towards self-care that will be described in five major themes. For the tensions with self-care, the authors developed two primary themes: leaders eat last and keep from falling off the cliff. For the demonstrations of self-care, the authors also developed three primary themes: release the endorphins, people need people and unplug from work.Originality/valueAlthough researchers have identified the stressors and reactions of principals during the early months of the COVID-19 pandemic, little is known on how principals engaged in self-care practices. This study aims to identify these self-care practices and offer recommendations for principals.

Background Intronic WT1 mutations are usually causative of Frasier syndrome with focal segmental glomerulosclerosis as the characteristic nephropathy. Membranoproliferative glomerulonephritis is not commonly associated with disorders of sex development but has been recently identified as a WT1-associated nephropathy, but usually in cases of exonic mutations in either isolated Wilms tumor or Denys-Drash syndrome. Methods The clinical and genetic data from 3 individuals are reported. Results This report describes the kidney manifestations in 3 individuals from 2 unrelated families with Frasier syndrome intronic WT1 mutations, noting that 2 of the 3 individuals have histologically confirmed membranoproliferative glomerulonephritis. Conclusions These case reports support expansion of the clinical spectrum of the kidney phenotypes associated with Frasier syndrome providing evidence of an association between WT1 mutation and an immune complex-related membranoproliferative glomerulonephritis. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

La réalisation de ce rapport de recherche a été motivée par deux rapports de cas indépendants portant sur des personnes vivant en Alberta, au Canada, qui ont subi une perte de vision permanente en raison de normes de pratique inadéquates entourant les tests de la vue. Les tests de la vue sont habituellement effectués par des opticiens indépendamment des examens oculovisuels complets. Une description des deux rapports de cas et une discussion sur les risques associés aux tests de la vue fournissent des données probantes liées au danger danger pour la santé publique que présentent ces tests. Afin d’étudier les méthodes possibles de réduction ou d’élimination des risques liés aux tests de la vue en Alberta, nous avons effectué une recension des lois et des normes de pratique régissant les tests de la vue au Canada, aux États-Unis, en Nouvelle-Zélande et au Royaume-Uni. Notre recension indique que l’interdiction pure et simple d’effectuer des tests de la vue en Alberta serait le meilleur moyen de protéger l’intérêt public et de réduire les cas évitables de perte de vision. Comme on le constate dans d’autres provinces canadiennes, d’autres approches pour réduire les risques associés aux tests de la vue comprennent 1) l’élaboration et l’application de restrictions concernant l’exécution des tests de la vue et 2) l’élaboration de scénarios clairement définis dans lesquels les opticiens collaborent avec les prescripteurs autorisés pour effectuer des tests de la vue en toute sécurité.

Les examens de réfraction comptent parmi les nombreuses procédures diag-nostiques effectuées par les optométristes et les ophtalmologistes en vue de prescrire des lunettes. En Alberta, les optométristes et les ophtalmologistes sont autorisés à effectuer des examens de réfraction et à prescrire des lunettes en fonction des résultats. Les opticiens sont aussi autorisés à effectuer des examens de réfraction sans toutefois avoir le droit de prescrire de lunettes. Cette étude vise à déterminer si la population a besoin que les opticiens soi-ent autorisés à effectuer des examens de réfraction et à prescrire des lunettes en solo compte tenu de la répartition géographique actuelle des optomé-tristes et des ophtalmologistes en Alberta. Pour répondre à cette question, les ratios des optométristes et des ophtalmologistes par rapport à la population pour chacune des cinq régions sanitaires de l’Alberta ont été calculés et com-parés aux ratios internationaux. Nos résultats montrent que les cinq régions sanitaires de l’Alberta ont des ratios optométriste-population qui atteignent ou dépassent l’indice de référence international de 1 pour 10 000 personnes permettant de répondre aux besoins de la population et que trois des cinq régions sanitaires ont des ratios ophtalmologiste-population équivalents ou supérieurs à l’indice de référence international de 3 pour 100 000 personnes qui permet de répondre aux besoins de la population. Ces données indiquent que la répartition des optométristes est adéquate dans la province mais que celle des ophtalmologistes est inadéquate. Compte tenu de la disponibilité ac-tuelle des optométristes et des ophtalmologistes en Alberta, il n’est pas néces-saire que les opticiens soient autorisés à effectuer des examens de réfraction et à prescrire des lunettes en solo.

A refraction is one of several tests performed by optometrists and ophthalmologists to issue a patient’s prescription for glasses. In Alberta, optometrists and ophthalmologists are authorized to perform refractions and prescribe based on that refraction; however, opticians are only authorized to refract. This study investigates whether there is a public need for opticians to be licensed to perform refractions and prescribe based on that refraction based on the adequacy of the geographic distribution of eye care professionals in Alberta. To answer this question, the optometrist and ophthalmologist to population ratios for each of Alberta’s five health zones were calculated and compared to international benchmarks. Our results show that all five of Alberta’s health zones have optometrist to population ratios that either meet or exceed the 1:10,000 international benchmark, and three of the five health zones have ophthalmologist to population ratios that meet or exceed the 3:100,000 international benchmark. Based on this data, there is an adequate distribution of optometrists but an inadequate distribution of ophthalmologists in the province. However, in regard to refractions, there is no overwhelming public need for opticians to refract and prescribe based on the refraction.

L’Alberta est l’une des trois provinces canadiennes qui autorisent les opticiens à effectuer des examens de la réfraction. Récemment, l’Alberta College and Asso-ciation of Opticians (ACAO) a demandé que le champ d’exercice des opticiens soit élargi pour inclure la capacité de prescrire des appareils optiques, qui est actuellement réservée aux optométristes et aux ophtalmologistes. Tout au long du présent document, le terme « prescrire » devrait être interprété comme la prescription d’un appareil optique, et non comme celle d’un agent pharmaceu-tique thérapeutique. Dans le présent document, nous cherchons à déterminer si les opticiens qui effectuent des examens de la réfraction désignés en Alberta ont une formation et des connaissances adéquates pour exécuter un examen et pre-scrire un appareil optique de façon autonome en toute sécurité. Pour répondre à cette question de recherche, nous avons dressé une liste de 27 compétences qui selon nous sont requises pour prescrire et faire des examens de la réfrac-tion de façon autonome en toute sécurité. Nous avons ensuite évalué les pro-grammes d’optique du Northern Alberta Institute of Technology (NAIT) et les examens d’entrée dans la profession administrés par l’Association nationale des autorités de réglementation des opticiens du Canada (NACOR) de même que le Bureau des examinateurs en optométrie du Canada (BEOC) pour déterminer s’ils couvrent ces 27 compétences. Nos constatations montrent que les pro-grammes de sciences optiques du NAIT ne couvrent pas ou n’évaluent pas dans la pratique plus de la moitié (59 %) des compétences requises pour prescrire et exécuter des examens de la réfraction de façon autonome en toute sécurité, et que l’examen de la NACOR ne couvre pas 77 % de ces compétences. Selon cette information, les opticiens qui effectuent des examens de la réfraction désignés en Alberta ne possèdent pas la formation et les connaissances nécessaires pour exécuter cet examen et prescrire un appareil optique de façon autonome en toute sécurité. Le fait d’accorder aux opticiens le pouvoir légal de prescrire et d’exécuter des examens de façon autonome peut donner lieu à un problème de santé publique, car il pourrait y avoir une augmentation du nombre de maladies oculaires et systémiques non diagnostiquées ou non détectées.

Alberta is one of three Canadian provinces that permits optician-performed refractions. Recently, the Alberta College and Association of Opticians (ACAO) has requested an expansion of opticians’ scope of practice to include the ability to prescribe optical appliances, an activity currently restricted to optometrists and ophthalmologists. For the remainder of this paper, the term “prescribe” should be interpreted as the prescription of an optical appliance, not a therapeutic pharmaceutical agent. In this paper, we investigate whether designated refracting opticians in Alberta have adequate training and knowledge to safely and independently perform a refraction and prescribe an optical appliance. To answer this research question, we composed a list of 27 skills we deem necessary to safely and independently refract and prescribe. We then evaluated the Northern Alberta Institute of Technology’s (NAIT) opticianry programs and the entry to practice examinations administered by the National Association of Canadian Optician Regulators (NACOR) and the Optometry Examining Board of Canada (OEBC) in terms of their coverage of these 27 skills. Our findings show that NAIT’s optical science programs either do not cover or do not practically assess students on over half (59 percent) of the skills required to safely and independently refract and prescribe, and the NACOR examination fails to cover 77 percent of the skills required to safely refract and prescribe. Based on this information, refracting opticians in Alberta do not possess adequate training and knowledge to safely and independently perform a refraction and prescribe an optical appliance. Granting opticians the legislative authority to independently refract and prescribe may result in a public health issue, as there may be an increase in the number of un-diagnosed or un-detected eye and systemic diseases.

PurposeThe authors demonstrate the usage of data visualization for conveying educational administration research, with a specific focus on differential principal turnover. They model when and how principals move, over time, between six categories of turnover.Design/methodology/approachThe authors construct several easy-to-interpret alluvial diagrams that reveal the patterns of differential turnover among 1,113 first-time Texas principals. Furthermore, the authors investigate how these patterns differ across educator characteristics (i.e. race and sex) and school contexts (i.e. school level and campus urbanicity).FindingsHalf of all first-time principals turn over within two years. Most principals who stay in leadership roles leave the district where they were first entered the principalship. Men are promoted more and women turn over less. In a connected finding, the authors conclude that elementary principals turn over less, and middle and high school principals are promoted more often. Principals of color are demoted more often than White principals. Urban school principals exit the system at a greater rate than rural principals.Originality/valueThe significance of this study lies in its direct response to two problems facing the administrator turnover knowledge base – a lack of methodological accessibility and the underutilization of data visualization. The authors’ is the first study to contain visualization of differential turnover outcomes over time. Second, the authors’ study provides a blueprint for data visualization that not only creates new knowledge but also speaks to a wider variety of education stakeholders by presenting complex data in a visual format.

PurposePrincipal preparation program pedagogy and course delivery are critical to principal candidates' preparedness to lead. Research around online program delivery, however, is relatively sparse. This study examined the extent to which university-based educational leadership programs offered fully online (FOL) pathways to the principalship, as well as program geographic locations and institutional characteristics most associated with FOL offerings.Design/methodology/approachData were collected through website reviews and coding checks, and then merged with national postsecondary data. Data were analyzed using descriptive statistics, classification tree analysis, and geographic information system (GIS) mapping.FindingsRoughly 43 percent of all reviewed programs offered an FOL pathway to licensure, which suggests substantial growth in FOL offerings over the last 10 years. While a number of factors were deemed important, geographic characteristics were most associated with FOL status. GIS mapping further illustrated findings with a visual landscape of program FOL offerings.Research limitations/implicationsThis study considered only programs for which degrees or certificates could be earned without ever visiting campus in-person for classes. Hybrid programs were excluded from the analysis.Practical implicationsFindings make a clear call for more research into online principal preparation program design and course delivery.Originality/valueThis study provides the first overview of fully online university-based principal preparation programs in the United States while also offering a previously unavailable landscape of all programs specifically leading to licensure. It is also the only higher education study to map or investigate factors associated with FOL offerings and raises questions about prior FOL higher education research.

This research report is motivated by two independent case reports featuring individuals living in Alberta, Canada who experienced permanent vision loss as a result of inadequate standards of practice surrounding sight tests. Sight tests are usually performed by opticians and are conducted independently of a comprehensive eye exam. A description of the two case reports in addition to a discussion of the potential dangers of sight tests provide evidence of the public health risks associated with sight tests. To investigate potential approaches to reduce or eliminate the risks of sight tests in Alberta, we conducted a jurisdictional review examining the laws and standards of practice governing sight tests in Canada, the United States, New Zealand, and the United Kingdom. Based on the jurisdictional review, the outright prohibition of sight tests in Alberta may be the best approach to protect the public interest and reduce cases of avoidable vision loss. As seen in other Canadian provinces, alternative approaches to reduce the risk of sight tests may involve 1) developing and enforcing restrictions around the performance of sight tests or 2) developing clearly defined scenarios in which opticians can collaborate with authorized prescribers to deliver safe sight tests.

Significant reduction in quality of life among patients with autoimmune hepatitis (AIH) patients has been observed in several studies. While acute symptoms associated with AIH have been well described, little is known about the overall impact of living with AIH on patients' quality of life. The aim of this qualitative descriptive study was to describe the impact of AIH and associated symptoms on quality of life from the perspectives of patients living with AIH.Patients from Autoimmune Hepatitis Association support groups were recruited to participate in one of five online focus groups conducted between August and September 2020. After enrollment, patients were asked to complete a brief demographic and disease history questionnaire. A single moderator conducted interviews with each group guided by seven questions focused on the impact of AIH on the participants' quality of life. Each session was recorded, transcribed, and verified. Content analysis was used to summarize the participants' responses.The participants' discussed three overarching topics: (a) symptoms of AIH and medication side effects, (b) the impact the disease and symptoms/side effects on five domains of quality of life (work life, relationships with friends and family, social life, leisure activities, and diet and exercise) and (c) interactions with healthcare providers and recommendations for future research.Living with AIH can have profound effects on patients' quality of life in several domains. Healthcare providers and the AIH research community should focus on developing further strategies that can improve the quality of life in persons suffering from AIH.

The authors piloted a weight stigma psychotherapy group at an eating disorder partial hospitalization (PHP) and intensive outpatient program (IOP). This was an optional, transdiagnostic eating disorder group for patients with past/present weight stigma experiences related to being in large bodies. A total of 36 individuals participated in the weekly group from June 2018 to June 2019 during their PHP/IOP episode of care. We present the group's overarching framework of destigmatizing language and intersectional discussions of weight stigma. We also discuss clinical processes that unfolded during this group including simulated dialog from the group. Finally, we present relevant client quotes that provide preliminary support for future exploration in this area, as client subjective experiences of the group were positive. Our preliminary pilot experience suggests that delivering a group of this nature in a PHP/IOP eating disorder treatment setting is feasible and that further work is needed to build upon this antiweight stigma framework as a critical piece of eating disorder treatment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Research indicates that preparation programs featuring partnerships between universities and districts have a greater impact on career advancement of graduates than more conventional university-bas...

As the collection and dissemination of “big data” become easier, we are exposed to increasing numbers of visuals, or infographics, that convey this data. Students are likely to interact wit...

Children’s understanding of rewards for task completion was examined in the context of gender, and gender-based stereotypes. Eighty-eight children (43 girls, Moverall = 58.39 months) completed a measure assessing gender-based occupational stereotypes. This measure, along with gender, was used to predict children’s self-reward for undergoing the testing, as well as their reward for a fictional other child having undergone the same procedure. The methodology provided a novel approach for studying reward allocation in children, as it did not require children to divide resources between themselves and another child for completing the same task. An occupation-based stereotype measure was found to predict the self-reward, as well as the reward allocated to the other child. In addition, the participant’s gender predicted self-reward, and an interaction between participant gender and gender of the experimenter contributed to predicting the other child reward. Overall, these findings suggest that gender an...

A few commonly used non-antibiotic drugs have recently been associated with changes in gut microbiome composition, but the extent of this phenomenon is unknown. Here, we screened more than 1,000 marketed drugs against 40 representative gut bacterial strains, and found that 24% of the drugs with human targets, including members of all therapeutic classes, inhibited the growth of at least one strain in vitro. Particular classes, such as the chemically diverse antipsychotics, were overrepresented in this group. The effects of human-targeted drugs on gut bacteria are reflected on their antibiotic-like side effects in humans and are concordant with existing human cohort studies. Susceptibility to antibiotics and human-targeted drugs correlates across bacterial species, suggesting common resistance mechanisms, which we verified for some drugs. The potential risk of non-antibiotics promoting antibiotic resistance warrants further exploration. Our results provide a resource for future research on drug-microbiome interactions, opening new paths for side effect control and drug repurposing, and broadening our view of antibiotic resistance.