: Prolactin (PRL), secreted by the pituitary, decidua, and lymphoid cells, has been shown to have a regulatory role in reproduction, immune function, and cell growth in mammals. The effects of PRL ...are mediated by a membrane‐bound receptor that is a member of the superfamily of cytokine receptors. Formation of a trimer, consisting of one molecule of ligand and two molecules of receptor, appears to be a necessary prerequisite for biological activity. The function of these receptors is mediated, at least in part, by two families of signaling molecules: Janus tyrosine kinases (JAKs) and signal transducers and activators of transcription (STATs). To study these receptors, we have used two approaches: mutational analysis of their cytoplasmic domains coupled with functional tests and inactivation (knockout) of the receptor gene by homologous recombination in mice. We have produced mice by gene targeting in embryonic stem cells carrying a germline null mutation of the prolactin receptor gene. Heterozygous (+/‐) females show almost complete failure to lactate, following their first, but not subsequent pregnancies. Homozygous (‐/‐) females are infertile as a result of multiple reproductive abnormalities, including ovulation of premiotic oocytes, reduced fertilization of oocytes, reduced preimplantation oocyte development, lack of embryo implantation, and the absence of pseudopregnancy. Half of the homozygous males are infertile or show reduced fertility. In view of the widespread distribution of PRL receptors, other phenotypes including those on the immune system, are currently being evaluated in ‐/‐ animals. This study establishes the prolactin receptor as a key regulator of mammalian reproduction and provides the first total ablation model to further study the role of the prolactin receptor and its ligands.
Human PRL is synthesized and secreted by the maternal decidua, but not by the chorionic cytotrophoblast of the chorion laeve or the placenta. The sites of action for decidual PRL are currently ...unknown. Accordingly, Northern analysis and in situ hybridization histochemistry have been used respectively to quantitate and localize the expression of the PRL receptor (PRL-R) gene within the uterus during the peripartal period. Immunocytochemistry and Western blot analysis using an anti-PRL-R antibody (U5) localized the translated protein at the cellular level in the same tissues. As judged by the level of expression of the PRL-R gene and its translated products, the chorionic cytotrophoblast has been shown to be a primary site of action. Novel sites were also shown in the decidua, placental trophoblast, and amniotic epithelium. In situ hybridization was not obtained in the latter despite positive Northern analysis and immunostaining. Western analyses with an antibody (U5) to the extracellular domain of the rat PRL-R detected six major molecular species of 95, 85, 63, less than 63, more than 30, and 30 kDa in cytosol from separated amnion, chorion, and decidua. The two bands at 95 and 85 kDa were approximate values only and represent the mature glycosylated forms of the human PRL-R. The other four major bands were partial degradation products from the PRL-R, showing tissue-specific processing and patient to patient variation related to the spectrum of proteases present in these tissues. The 63- and 30-kDa PRL-R-related proteins were detected in both the cytosol and medium from amnion, chorion, and decidua and were also present in amniotic fluid. The 30-kDa species was equal in size to a recently reported PRL-binding protein in human milk. The release of these two PRL-R-related proteins into amniotic fluid suggests possible functions as binding and or/PRL transport proteins in these tissues. The more than 30-kDa species was detected in high amounts in both cytosol and medium from the decidua, but was absent from amniotic fluid. Further work is required to clarify the structural relationships and potential functions of these immunologically PRL-R-related proteins. This study shows that the PRL-R is widely expressed by both fetal and maternal tissues in late pregnancy. Its increased expression during labor and delivery in the chorion, decidua, and placenta supports an autocrine/paracrine role for decidual PRL in the peripartum.
Background
It is widely accepted that the therapeutic alliance (TA) is a mediator of psychotherapy effects, but evidence is sparse that the TA is an actual mechanism of behavior change. The purpose ...of this study was to provide the first systematic evidence regarding the TA as a mechanism of change in the treatment of alcohol use disorder (AUD).
Methods
Participants were 155 adult men and women presenting for individual outpatient treatment of AUD. Each was randomly assigned to 1 of 6 experienced therapists, who did or did not receive over 3 study phases postsession participant feedback on his/her ratings of the TA. All participants received a 12‐session version of cognitive behavioral therapy for AUD. Participants rated the TA by use of the California Psychotherapy Alliance Scale (CALPAS) and reported their daily alcohol consumption between sessions and for 1 year posttreatment by use of the timeline followback interview. Multilevel statistical models that partitioned within‐ and between‐participant effects and between‐therapist effects were run to test the effects of feedback condition on the alliance and alcohol use, and the effects of the alliance on alcohol use.
Results
The study's main hypotheses that feedback causes an enhanced therapeutic alliance and that the alliance is associated with better alcohol use outcomes were not supported.
Conclusions
Several methodological and substantive reasons for the pattern of findings are suggested, as well as directions for future research that would advance study of the TA as a mechanism of change in psychotherapy and in studying therapist effects on outcomes in general.
This study highlights the importance of several factors that might be incorporated in research designs to study the therapeutic alliance as a mechanism of alcohol use disorder treatment‐related changes in alcohol use and related outcomes.
Informal learning experiences in science, technology, engineering, and math (STEM) can enhance STEM learning that occurs in formal educational settings and curricula as well as generate enthusiasm ...for considering STEM careers. The aim of this systematic review is to focus on the experiences of neurodiverse students in informal STEM learning. Neurodiversity is a subgroup of neurodevelopmental conditions, such as autism, attention deficit disorder, dyslexia, dyspraxia, and other neurological conditions. The neurodiversity movement regards these conditions as natural forms of human variation, as opposed to dysfunction, and recognizes that neurodiverse individuals possess many strengths relevant to STEM fields.
The authors will systematically search electronic databases for relevant research and evaluation articles addressing informal STEM learning for K-12 children and youth with neurodiverse conditions. Seven databases and content-relevant websites (e.g., informalscience.org) will be searched using a predetermined search strategy and retrieved articles will be screened by two members of the research team. Data synthesis will include meta-synthesis techniques, depending on the designs of the studies.
The synthesis of the findings resulting from various research and evaluation designs, across the K-12 age span, and across various informal STEM learning contexts, will lead to depth and breadth of understanding of ways to improve informal STEM learning programs for neurodiverse children and youth. The identification of informal STEM learning program components and contexts shown to yield positive results will provide specific recommendations for improving inclusiveness, accessibility, and STEM learning for neurodiverse children and youth.
The current study has been registered in PROSPERO.
CRD42021278618.
Highlights • Unsafe injection practices were reported by both surveyed physicians and nurses. • 12% of physicians and 3% of nurses indicated syringe reuse occurs in their workplace. • A multifaceted ...approach is needed to combat unsafe injection practices. • The One & Only Campaign is an injection safety resource for health care providers.
We report on the various responses in Australia during 2020 to minimize negative impacts of the COVID-19 pandemic on the welfare of animals. Most organizations and individuals with animals under ...their care had emergency preparedness plans in place for various scenarios; however, the restrictions on human movement to contain the spread of COVID-19, coupled with the economic impact and the health effects of COVID-19 on the skilled workforce, constituted a new threat to animal welfare for which there was no blueprint. The spontaneous formation of a national, multisectoral response group on animal welfare, consisting of more than 34 organizations with animals under their care, facilitated information flow during the crisis, which helped to mitigate some of the shocks to different organizations and to ensure continuity of care for animals during the pandemic. We conclude that animal welfare is a shared responsibility, and accordingly, a multisectoral approach to animal welfare during a crisis is required. Our experience demonstrates that to safeguard animal welfare during crises, nations should consider the following: a national risk assessment, clear communication channels, contingency plans for animal welfare, a crisis response group, and support systems for animal care providers. Our findings and recommendations from the Australian context may inform other countries to ensure that animal welfare is not compromised during the course of unpredictable events.
Background Previous research demonstrates that organizational culture (OC) and knowledge, attitudes, and practices of health care personnel are associated with the overall success of infection ...control programs; however, little attention has been given to the relationships among these factors in contributing to the success of quality improvement programs. Methods Cross-sectional surveys assessing OC and knowledge, attitudes, and practices related to methicillin-resistant Staphylococcus aureus (MRSA) were distributed to 16 medical centers participating in a Veterans Affairs MRSA prevention initiative in 2 time periods. Factor analysis was performed on the OC survey responses, and factor scores were generated. To assess associations between OC and knowledge, attitudes, and practices of health care personnel, regression analyses were performed overall and then stratified by job type. Results The final analyzable sample included 2,314 surveys (43% completed by nurses, 9% by physicians, and 48% by other health care personnel). Three OC factors emerged accounting for 53% of the total variance: “Staff Engagement,” “Overwhelmed/Stress-Chaos,” and “Hospital Leadership.” Overall, higher Staff Engagement was associated with greater knowledge scores, better hand hygiene practices, fewer reported barriers, and more positive attitudes. Higher Hospital Leadership scores were associated with better hand hygiene practices, fewer reported barriers, and more positive attitudes. Conversely, higher Overwhelmed/Stress-Chaos scores were associated with poorer reported prevention practices, more barriers, and less positive attitudes. When these associations were stratified by job type, there were significant associations between OC factors and knowledge for nurses only, between OC factors and practice items for nurses and other health care personnel, and between OC factors and the barriers and attitudes items for all job types. OC factors were not associated with knowledge and practices among physicians. Conclusions Three OC factors—Staff Engagement, Overwhelmed/Stress-Chaos, and Hospital Leadership—were found to be significantly associated with individual health care personnel knowledge, attitudes, and self-reported practices regarding MRSA prevention. When developing a prevention intervention program, health care organizations should not only focus on the link between OC and the knowledge, attitudes, and practices of health care personnel, but also target programs based on health care personnel type to maximize their effectiveness.
Background/Objectives
The psychological effect of alopecia areata (AA) is well documented, but group interaction may help lessen this burden. We aimed to determine factors that draw patients with AA ...and their families to group events.
Methods
Surveys were administered at the annual alopecia areata bowling social in 2015 and 2016. This event is a unique opportunity for children with AA and their families to meet others with the disease and connect with local support group resources from the Minnesota branch of the National Alopecia Areata Foundation. Data from 2015 and 2016 were combined. Comparisons of subgroups were performed using Fisher exact tests for response frequencies and percentages and two‐sample t tests for mean values.
Results
An equal number of men and women participated in the study (n = 13 each). The average age was 41.1 years. There were no significant differences (p > 0.05) in survey responses based on respondent age or sex. Twenty‐three (88.5%) attendees sought to connect with others with AA and met three or more people during the event. Seventeen (65.4%) also attended other support group events. Twelve respondents (46.2%) came to support a friend or family member. One hundred percent of attendees identified socializing with others with AA as important.
Conclusions
Group interaction is an important source of therapeutic support for people with AA and their families.