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We developed a curriculum for community health workers (CHWs) using an innovative, community-engaged focus group and Delphi process approach. Equipping CHWs with knowledge of Hereditary Breast and Ovarian Cancer (HBOC) and genetics could help enhance identification of women at risk for HBOC, referral, and navigation through genetic services. Focus groups of five CHWs were conducted on two separate occasions. A three round Delphi process study involving eight experts was conducted. In Round 1 participants rated and commented on draft modules. The second round involved live video discussion to highlight points of confusion and concern in the modules. The third round followed the same process as Round 1. Eight individuals participated in the Delphi process. The curriculum was revised and refined based on quantitative and qualitative data and reassessed by the experts in Round 3. Agreement was achieved on eight of 10 modules when assessing for clarity of learning objectives, seven out of 10 when assessing for adult learning theory, and nine out of 10 when assessing for participants’ ability to learn desired knowledge and the Delphi process concluded. High levels of agreement were attained for most modules, and if not, they were altered accordingly. We plan to virtually deliver this curriculum to CHWs to enhance their HBOC and genomic competencies. By equipping CHWs to understand and participate in genomics education, we can enable more equitable participation in genomics-informed clinical care and research. Beyond this curriculum, the Delphi methodology can further be used to design content for new CHW curriculums.

First responders lose their lives in the line of duty each year, and many of these deaths result from strenuous physical exertion and exposure to harmful environmental agents. Continuous health monitoring may detect diseases and alert the first responder when vital signs are reaching critical levels. However, continuous monitoring must be acceptable to first responders. The purpose of this study was to discover first responders’ current use of wearable technology, their perceptions of what health and environmental indicators should be monitored, and who should be permitted to monitor them. The survey was sent to 645 first responders employed by 24 local fire department stations. A total of 115 (17.8%) first responders answered the survey and 112 were used for analysis. Results found first responders perceived a need for health and environmental monitoring. The health and environmental indicators that respondents perceived as most important for monitoring in the field were heart rate (98.2%) and carbon monoxide (100%), respectively. Overall, using and wearing monitoring devices was not age-dependent and health and environmental concerns were important for first responders at any stage of their career. However, current wearable technology does not seem to be a viable solution for first responders due to device expense and durability issues.

The coronavirus disease 2019 (COVID-19) pandemic requires the continued development of safe, long-lasting, and efficacious vaccines for preventive responses to major outbreaks around the world, and especially in isolated and developing countries. To combat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we characterize a temperature-stable vaccine candidate (TOH-Vac1) that uses a replication-competent, attenuated vaccinia virus as a vector to express a membrane-tethered spike receptor binding domain (RBD) antigen. We evaluate the effects of dose escalation and administration routes on vaccine safety, efficacy, and immunogenicity in animal models. Our vaccine induces high levels of SARS-CoV-2 neutralizing antibodies and favorable T cell responses, while maintaining an optimal safety profile in mice and cynomolgus macaques. We demonstrate robust immune responses and protective immunity against SARS-CoV-2 variants after only a single dose. Together, these findings support further development of our novel and versatile vaccine platform as an alternative or complementary approach to current vaccines., Graphical abstract, To combat SARS-CoV-2, we characterize a novel vaccine candidate (TOH-Vac1) that uses a replication-competent, attenuated vaccinia virus as a vector to express a membrane-tethered spike receptor binding domain antigen. We evaluate the effects of dose escalation and administration routes on vaccine safety, efficacy, and immunogenicity in mice and cynomolgus macaques.

Sexual abuse can result in significant negative sequelae for victims. One particularly harmful consequence is suicidal ideation, which can lead to suicide attempts and even death. It is essential to screen children and adolescents for suicidal ideation when providing medical forensic care after disclosure of acute or nonacute sexual abuse/assault. Forensic nurses must feel confident in their abilities to assess suicide risk and provide appropriate intervention and referrals. A thorough understanding of the relationship between sexual abuse and suicidal ideation and behaviors can assist the forensic nurse in the development of practice behaviors to better identify, intervene, and prevent suicidal ideation and behaviors among youth experiencing sexual abuse.

Aim ‘Golden local anaesthetic’ (GLA) principals are known to improve theatre efficiency. This first GLA case should be suitable to be completed unsupervised by a registrar and confirmed 12 hours prior to the start of the list with a negative COVID PCR test. This allows for list to be started, whilst the consultant is able to see and consent the remainder of the patients for that list, maximising theatre efficiency. Method Operative timings was gathered in real time in our electronic database (TIMS). Initially, retrospective analysis was performed for cases in November 2020, comparing lists whereby a potential GLA first case was present, versus lists that did not. After remodelling this process, lists in October 2021 were analysed. Statistical analysis was carried out using Mann Whitney U Test. Results Initially (PDSA-1), 110 trauma cases (58% GA and 42% LA) were performed [3.67/day] whilst post refinement (PDSA-2) 122 cases (52% GA and 48% LA) were performed [3.94 /day]. In PDSA-2, there was a 29% (9/31) uptake of GLA list principals. The average GLA list start time was 09:27hrs in PDSA-1 and 09:08hrs in PDSA-2 [Δ 19 mins, p Conclusions The GLA model is a simple and sustainable method to improve theatre efficiency which could be adopted by other units. (1) Ang WW et al. 2016 - doi:10.1016/j.amsu.2016.03.001

This article describes the thinking and processes involved in initiating the National Diversity Working Group: Power, Privilege and Position (PPP) at the Institute of Group Analysis (IGA) in the UK. It argues that while group analysis is in theory distinguished by a commitment to engaging in power differences and wider socio-political issues, this theory has not hitherto been deeply reflected in practice in the institutional culture of the IGA, reflecting a disconnect between theory and practice. This article suggests that in practice there has been lived experience of a culture of various institutional prejudices. In this context there was an increasingly urgent need to take action to address the intransigent culture around power and difference at the IGA. The PPP was needed as a response to the entrenched anti-group processes at work in maintaining institutional prejudices. Positive responses to addressing institutional racism have created opportunities for organizational change. The article explores how the PPP working group’s responses to addressing institutional racism worked to support organizational change and how this work has been instituted throughout the wider community. The article emphasizes how in response to the Black Lives Matter movement (BLM), issues concerning race have recently become focal in the PPP’s life and therefore form the focus of the article. Drawing on Brown’s notion of the ‘Monitor of Justice’ it argues that in setting up the PPP there was a harnessing of hitherto marginalized but pro-social group norms in the IGA culture in the face of anti-social institutional prejudice. In this context the article contains a detailed reflection of the lived experience of a black group analyst taking on a key leadership role in the organization by becoming the Chair of the PPP. It describes how under this leadership, working collaboratively with colleagues, PPP has become a highly innovative and creative centrifugal force in the IGA within two years. It tracks the process of culture change and how creating a safe space for experiences of marginalization within organizations can lead to wider system changes that increase inclusivity. When institutions can remain open and not become defensive about these experiences, this can lead to the wider culture being able to integrate these important experiences and adapt.

Art therapy in prisons remains widely under-researched in Australia and beyond and represents a major gap in the literature. Despite evidence that art therapy can be a tool for social change, to date, there are no recorded studies in Australia which have investigated the therapeutic benefits of art in prison populations with measured outcomes. Literary analysis suggests that research tends to be hampered by limitations in methodological approaches that are suited to prison environments. By engaging “inside” with inmates over the course of an 8-week art therapy program, this research design addresses this knowledge gap. Building on 5 years of piloting, the research methodological design presented in this paper embodies a prototype that promises to overcome the limitations of previous research approaches. This research agenda promises to facilitate creative interventions through sensitively attuned art therapy delivery. Benefits are expected to accrue to diverse stakeholder groups, including inmates, chaplaincy and parole services, voluntary facilitators, policymakers, criminologists, and taxpayers, among others.

The objective of the study was to examine current family medicine residency education in cancer survivorship and barriers to cancer survivorship education in the residency curriculum. Family medicine residency program directors (n = 628) were surveyed electronically between September 2019 and November 2019 through the Council of Academic Family Medicine Educational Research Alliance (CERA) annual program directory survey. Respondents (n = 250) answered questions regarding eventual cancer survivorship curriculum in their residency program, including interest and barriers to implementation. Program characteristics were assessed using univariate and multivariate analyses. Only 9.2% of family medicine residency program directors reported having a cancer survivorship curriculum. Sixty-nine percent of program directors reported they would implement a cancer survivorship curriculum if one was available. The most significant barrier to implementation of a cancer survivorship curriculum was insufficient time (39.6%) followed by lack of faculty expertise (26.9%). Respondents that reported lack of faculty expertise as a barrier to implementation of cancer survivorship training were more likely be report that they would be willing to implement a cancer survivorship curriculum (p

PURPOSE: Physical activity is important for enhancing quality of life and cancer control among prostate cancer survivors. The purpose of this study was to examine characterize adherence to physical activity guidelines among African American and white prostate cancer survivors based on social and clinical determinants and psychosocial factors. METHODS: Observational study of meeting guidelines for moderate intensity physical activity in a retrospective cohort of African American and white prostate cancer survivors (n=89). RESULTS: Thirty-four percent of survivors met the recommended guidelines for moderate intensity physical activity. There were no racial differences in physical activity between African American and white prostate cancer survivors; however, the likelihood of meeting guidelines was associated significantly with stage of disease, self-rated health, and perceptions of stress. Survivors who had stage pT2c or higher disease had a significantly reduced likelihood of meeting recommended guidelines for physical activity (OR=0.27, 95% CI=0.08, 0.86, p=0.03). The likelihood of meeting guidelines was also reduced among survivors who rated their health as being the same or worse than before they were diagnosed with prostate cancer (OR=0.32, 95% CI=0.11, 0.96, p=0.04). As perceived stress increased, the likelihood of being physically active according to guidelines also decreased (OR=0.48, 95% CI=0.26, 0.89, p=0.02). CONCLUSION: The results of this study underscore the need to develop, implement, and evaluate strategies to enhance physical activity among prostate cancer survivors, regardless of their racial background. Complementary and alternative strategies for physical activity may be one strategy for enhancing activity levels and managing stress among prostate cancer survivors.

Adverse childhood experiences (ACEs) impact both physical and emotional health throughout the lifespan and contribute to negative effects in childhood such as learning difficulties, internalizing a...

Background Peer-review networks aim to help services to improve the quality of care they provide, however, there is very little evidence about their impact. We conducted a cluster randomized controlled trial of a peer-review quality network for low-secure mental health services to examine the impact of network membership on the process and outcomes of care over a 12 month period. Methods Thirty-eight low secure units were randomly allocated to either the active intervention (participation in the network n = 18) or the control arm (delayed participation in the network n = 20). A total of 75 wards were assessed at baseline and 8 wards dropped out the study before the data collection at 12 month follow up. The primary outcome measure was the quality of the physical environment and facilities of the services. The secondary outcomes included: safety of the ward, patient mental wellbeing and satisfaction with care, staff burnout, training and supervision. We hypothesised that, relative to control wards, the quality of the physical environment and facilities would be higher on wards in the active arm of the trial 12 months after randomization. Results The difference in the primary outcome between the groups was not statistically significant (4.1; 95% CI [− 0.2, 8.3] p = 0.06). The median number of untoward incidents rose in control services and remained the same at the member of the network (Difference between members and non-members = 0.55; 95% IC [0.29, 1.07] p = 0.08). At follow up, a higher proportion of staff in the active arm of the trial indicated that they felt safe on the ward relative to those in the control services (p = 0.04), despite reporting more physical assaults (p = 0.04). Staff working in services in the active arm of the trial reported higher levels of burnout relative to those in the control group. No difference was seen in patient outcomes. Conclusions We did not find evidence that participation in a peer-review network led to marked changes in the quality of the physical environment of low secure mental health services at 12 months. Future research should explore the impact of accreditation schemes and examine longer term outcomes of participation in such networks. Trial registration ISRCTN79614916. Retrospectively registered 28 March 2014.

Despite sequence similarity to SARS-CoV-1, SARS-CoV-2 has demonstrated greater widespread virulence and unique challenges to researchers aiming to study its pathogenicity in humans. The interaction of the viral receptor binding domain (RBD) with its main host cell receptor, angiotensin-converting enzyme 2 (ACE2), has emerged as a critical focal point for the development of anti-viral therapeutics and vaccines. In this study, we selectively identify and characterize the impact of mutating certain amino acid residues in the RBD of SARS-CoV-2 and in ACE2, by utilizing our recently developed NanoBiT technology-based biosensor as well as pseudotyped-virus infectivity assays. Specifically, we examine the mutational effects on RBD-ACE2 binding ability, efficacy of competitive inhibitors, as well as neutralizing antibody activity. We also look at the implications the mutations may have on virus transmissibility, host susceptibility, and the virus transmission path to humans. These critical determinants of virus–host interactions may provide more effective targets for ongoing vaccines, drug development, and potentially pave the way for determining the genetic variation underlying disease severity.

Despite sequence similarity to SARS-CoV-1, SARS-CoV-2 has demonstrated greater widespread virulence and unique challenges to researchers aiming to study its pathogenicity in humans. The interaction of the viral receptor binding domain (RBD) with its main host cell receptor, angiotensin-converting enzyme 2 (ACE2), has emerged as a critical focal point for the development of anti-viral therapeutics and vaccines. Utilizing our recently developed NanoBiT technology-based biosensor, we selectively identify and characterize the impact of mutating certain amino acid residues in the RBD of SARS-CoV-2 and in ACE2. Specifically, we examine the mutational effects on RBD-ACE2 binding ability, before and after the addition of competitive inhibitors, as well as neutralizing antibody activity. These critical determinants of virus-host interactions may provide more effective targets for ongoing vaccines, drug development, and potentially pave the way for determining the genetic variation underlying disease severity.

The biblical books of Acts (12:1; 12:5), Matthew (11:12) and Romans (16:7) all speak of the apostles Peter, Paul and John interacting in prison discipleship with other followers of Christ. These references are the first documentation of New Testament prison chaplaincy, and the Gospel of Matthew (25:36) goes even further, admonishing Christians to be actively involved in assisting prisoners in the place of their incarceration. Thus, prison chaplaincy has a long history and remains a fundamental right of prisoners (UN-OHCHR 1977). The significance of prison chaplaincy is particularly noted in the context of growing incarceration trends in Australia, which have seen adult prisoner populations increase significantly in the last decade to a total of more than 43,000 inmates (ABS 2019). Meanwhile recidivism has remained steady at 40% over the last 5 years (QCS 2019). Importantly, budget restraints have occasioned cutbacks in therapeutic and rehabilitation programs, thus resulting in a situation that is leaving a growing number of inmates with fewer restorative and rehabilitative opportunities. Furthermore, illiteracy rates remain high within prisons and only a limited number of inmates can read. It is against this background that art therapy is highlighted as an effective communication tool and therapeutic practice in prison environments. Art is also prevalent in the Bible and visual communication was used not only by Jesus but also by the early Church to communicate the biblical stories to different cultures. Through experiences both inside and out, the first author of this pilot study understands the implications and hurdles associated with rehabilitation whilst having convictions recorded. The analysis presented in this chapter synthesises lessons learned from developing and implementing the ‘Change the Design of Your Life’ art therapy program in Queensland prisons. Experiences and lessons gathered in this chapter will be useful for educators, policymakers, practitioners and chaplains serving the cause of social prison ministry in Australia and beyond.

The objective of the study was to examine current family medicine residency education in cancer survivorship and barriers to cancer survivorship education in the residency curriculum.Family medicine residency program directors (n = 628) were surveyed electronically between September 2019 and November 2019 through the Council of Academic Family Medicine Educational Research Alliance (CERA) annual program directory survey. Respondents (n = 250) answered questions regarding eventual cancer survivorship curriculum in their residency program, including interest and barriers to implementation. Program characteristics were assessed using univariate and multivariate analyses.Only 9.2% of family medicine residency program directors reported having a cancer survivorship curriculum. Sixty-nine percent of program directors reported they would implement a cancer survivorship curriculum if one was available. The most significant barrier to implementation of a cancer survivorship curriculum was insufficient time (39.6%) followed by lack of faculty expertise (26.9%). Respondents that reported lack of faculty expertise as a barrier to implementation of cancer survivorship training were more likely be report that they would be willing to implement a cancer survivorship curriculum (p 0.01).Despite the majority of primary care physicians providing care to cancer survivors, few family medicine residency programs have formal training in cancer survivorship care. There is interest in expanding family medicine residency training in cancer survivorship care among program directors.Gaining insight into the current educational curriculum and barriers to cancer survivorship training will lead to opportunities to improve residency training, and ultimately provide better care to cancer survivors in primary care settings.

The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic presents an urgent need for an effective vaccine. Molecular characterization of SARS-CoV-2 is critical to the development of effective vaccine and therapeutic strategies. In the present study, we show that the fusion of the SARS-CoV-2 spike protein receptor-binding domain to its transmembrane domain is sufficient to mediate trimerization. Our findings may have implications for vaccine development and therapeutic drug design strategies targeting spike trimerization. As global efforts for developing SARS-CoV-2 vaccines are rapidly underway, we believe this observation is an important consideration for identifying crucial epitopes of SARS-CoV-2.

Objective: To characterize rates of co-morbidity among prostate cancer patients treated with radical prostatectomy and to examine the association between co-mor­bidity status and race, clinical factors, and health behaviors for cancer control. Design/Study Participants: Retrospective cohort study among prostate cancer patients treated with radical prostatectomy. Setting: Academic medical center located in the southeastern region of the United States. Main Outcome Measure: Patients with at least one of five co-morbid conditions considered were categorized as having a co-morbidity, and those without any were categorized as not having a co-morbid condition. Co-morbid conditions consid­ered were hypertension, diabetes, heart problems, stroke, and high cholesterol, which had been recorded in the electronic medical record as part of their past medical history. Results: Fifty-one percent of participants had a co-morbidity, with hypertension being the most common. The average number of co-morbidities among study participants was .87. In a multivariate logistic regression analysis, being diagnosed with prostate can­cer within the past four years was associated with an increased likelihood of having a co-morbidity (OR=4.71, 95% CI=2.69, 8.25, P=.0001) compared with diagnosis five or more years ago. Age was also associated with an increased likelihood of having a co-morbidity (OR=1.30, 95% CI=1.005, 1.68, P=.05). In this study cohort, race, stage at diagnosis, and PSA level were not statisti­cally associated with co-morbidity status. Conclusion: Better chronic disease management is needed among prostate cancer survivors through more effective survivorship care planning and interventions that promote health behaviors. Ethn Dis. 2020;30(Suppl 1):185-192; doi:10.18865/ed.30.S1.185

Evidence indicates family caregivers of individuals living with dementia (ILwD) are at risk for diminished physical and mental health; which may decrease their quality of life and directly impact their ability to provide care. An interdisciplinary approach to self-care and skill-building for caregivers is provided in a virtual support group offered by Council on Aging in Sonoma County, CA. As part of the nonprofit’s Adult Day Program, the group is offered to client caregivers and has two goals: First, creating a community-based, long-term support system for ILwD who are aging-in-place; second, fostering a safe and supportive community for family caregivers, by providing opportunities to collaborate with peers and an interdisciplinary team that includes a Marriage and Family Therapist (MFT), an Occupational Therapist (OT), and a Recreation Therapist (the day program manager). The closed group model established through eight weekly sessions builds trusting relationships in a frame that combines: the OT client-centered and collaborative approach to problem-solving everyday challenges of caregiving, the MFT skills of creating a safe space for discussion and deeper exploration, and program staff insights regarding the ILwD’s current interests and abilities exhibited during Day Program activities. Sessions include an emotional check-in by group members; a brief overview of best-practices and common caregiving concerns related to a weekly topic; and an opportunity for caregivers to explore the integration of best-practices into daily routines, while also attending to their well-being as caregivers. Program evaluation and results related to the program’s effectiveness and implications for scalability will be discussed.

Purpose The purpose of this paper is to highlight theoretical and clinical similarities between therapeutic communities (TCs) and group analysis (GA). Design/methodology/approach Literature review shows comparison of TC and group-analytic concepts with illustrative case material. Findings Findings reveal many similarities between TCs and GA, but also significant divergences, particularly in practice. Practical implications This paper provides theoretical basis for TC practice, and highlights the need for greater theorising of TC practice. Social implications This paper highlights the importance of group-based treatment approaches in mental health. Originality/value This is the first paper to review the relevant literature and compare theory and practice in TCs and GA, highlighting their common roots in the Northfields Experiments in the Second World War.

Tendon injuries in the hand are common; they are usually open injuries requiring surgical intervention. In this article we discuss tendon injuries in terms of approach to repair beginning at the time of diagnosis through to the rehabilitation programmes and outcome measures commonly used in the UK. In general tendon injuries should be considered using Verdan's zones for both extensor and flexor injuries. Flexor tendons require a high strength repair and usually warrant a core suture with epitendinous reinforcement bearing in mind the importance of not disrupting glide with unnecessary suture bulk. Extensor tendons more proximally can be treated in the same way but distally require only a running suture in the flattened tendon ends. All tendon injuries require a period of protected mobilization with splinting aiming to protect the repair but reduce stiffness in other joints.

A 50-year-old male UK resident with a history of hypertension and hypercholesterolaemia presented to the emergency department with a 48-hour history of sudden onset bilateral thigh swelling and pain unrelieved by regular analgesia. 3 days prior to presentation, he performed a vigorous workout in the gym. His medications included ramipril 5 mg once daily and atorvastatin 20 mg at night time. He was a non-smoker and did not consume alcohol. He reported no known drug allergies. Physical examination confirmed bilateral swollen thighs, with no overlying skin changes, clinically suggestive of compartment syndrome. His creatine kinase was >50 000 IU with normal renal and liver function tests. Further investigation with MRI-identified prominent swelling of the vastus intermedius and medialis muscles, more marked on the left, with extensive diffuse short tau inversion recovery (STIR) signal hyperintensity and isointensity on T1 sequences, suggestive of rhabdomyolysis. He underwent bilateral fasciotomies of his thighs and aggressive intravenous fluid resuscitation with close monitoring of his electrolytes. Intraoperatively his muscle was healthy, with no evidence of haematoma or necrosis. His medication atorvastatin was stopped due to his rhabdomyolysis. 48 hours later, he returned to theatre and review of his fasciotomy wounds was unremarkable. 4 days later, he was discharged uneventfully. His postoperative recovery was complicated by a serous discharge from his left medial thigh wound. Further investigation with an ultrasound confirmed a 4×1×1cm multiloculated collection within the superficial tissue directly underlying the wound. An aspirate was performed and cultures revealed no growth. He remains under review in the department of plastic surgery. This case report discusses the aetiological spectrum, clinical presentation, pathophysiology, differential diagnosis, investigations, management and complications of rhabdomyolysis.

Jenkins performs an intersectional, feminist textual analysis of the first four seasons (2009–2012) of RuPaul’s Drag Race (RPDR) and its spinoff show, RuPaul’s Drag Race: Untucked!, to answer the question: How does RPDR reinforce or subvert racial and ethnic stereotypes? Jenkins employs theory from a number of disciplines, including critical race theory and multiple feminist theories. The contestants featured in the chapter include BeBe Zahara Benet, Alexis Mateo, Carmen Carrera, Madame LaQueer, Kenya Michaels, Manila Luzon, and Raja. Jenkins concludes that although RPDR does engage in some subversive behavior on an intersectional level, it ultimately reinforces harmful racist and xenophobic stereotypes.

In eukaryotes, 45S ribosomal RNA (rRNA) genes are tandemly arrayed at nucleolus organizer regions (NORs) (see Fig. 1A). Their transcripts, generated by RNA polymerase I (Pol I) in the nucleolus, are processed into the 18S, 5.8S, and 25-28S (depending on species) catalytic RNAs of ribosomes (Moss et al. 2007; Kressler et al. 2010; Hannan et al. 2013). The number of active 45S rRNA genes changes with the physiological needs of the cell (McStay and Grummt 2008; Tucker et al. 2010). For instance, Arabidopsis thaliana has ∼1500 rRNA genes per diploid genome (Copenhaver et al. 1995; Copenhaver and Pikaard 1996), with subtypes distinguishable by insertions/deletions at their 3′ ends (Fig. 1A). All subtypes are expressed immediately following germination, but by ∼10 d of seedling growth, the variant 1 subtype (Fig. 1A), accounting for ∼50% of all rRNA genes, is silenced via epigenetic mechanisms that include changes in DNA methylation and histone modification (Earley et al. 2006, 2010; Pontvianne et al. 2010, 2012). Chromatin modifications mediate rRNA gene dosage control in yeast, mouse, and human cells as well (Sandmeier et al. 2002; McStay and Grummt 2008; Grummt and Langst 2013). Figure 1. Partitioning of active and silent rRNA genes between the nucleolus and nucleoplasm. (A) Relationships between the nucleolus, NORs, and 45S rRNA gene repeats. The drawing at the top depicts a metaphase chromosome with the remnants of a nucleolus associated ... To examine the subnuclear distribution of active and silenced rRNA genes, we adapted fluorescence-activated sorting technology to isolate whole A. thaliana nuclei or nucleoli liberated from sonicated nuclei. Exploiting sequence variation among differentially expressed rRNA gene subtypes and mutations that disrupt rRNA gene chromatin modifications or copy number, we show that rRNA genes occupy alternative subnuclear compartments depending on their activity state.

This report presents a case where vibration training to the arm alone, as opposed to whole-body vibration, was used to aid rehabilitation to a serious traumatic injury. An improvement in soft tissue extensibility to a major traumatic wound to the wrist and forearm has been noted in a therapy plan including vibration under stretch. After 12 weeks of intensive therapy, a considerable improvement was seen in both the active extension of the wrist and the composite extension of all fingers. This may highlight the use of vibration, as an adjunct to therapy, to specific areas of the human body for improving outcome from traumatic injury. Level of Evidence IV.

Two ways in which the concrete intrudes into the therapeutic space of psychotherapy groups for traumatized refugees and asylum seekers are explored. Concrete intrusions, which are the result of historical traumatic events, are distinguished from those which are the result of the contemporary socio-political context. Groups can help work through the former as an essential part of the therapy and need to find ways of working with the latter. The historical intrusions are aligned to the loss of the ability to symbolize. Connections between the (interpersonal) loss of the ability to trust, which characterizes groups for this population, and the (intrapersonal) loss of the ability to symbolize are explored. With the use of clinical illustrations, the article emphasizes the way in which the group therapy setting provides a space in which to rebuild the ability to trust, which is so personally and politically poignant for this client group. Moreover, finding ways of working with contemporary intrusions may benefit trust and the therapeutic alliance.