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Canon law recognizes the pastor as the chief educational officer (CEO) of the parish school. However, recent studies demonstrate that seminaries do not prepare seminarians for work in or leadership of Catholic schools, and recent scholarship also demonstrates that an increasing number of seminarians lack the desire to lead a parish school. Our research study examined the post-seminary preparation of priests for leadership of parish schools. We also explored alternative governance models for Catholic schools. We conducted structured interviews with 10 national leaders to explore these two areas of interest. Our findings demonstrate that preparation of newly ordained and veteran priests for parish school leadership is woefully inadequate. Interviewees suggested that the pastor/principal relationship and school finance are two important topics that should be addressed in best practice preparation programs for school leaders. All 10 interviewees had difficulty imagining alternative governance models for schools in which the pastor would not serve as the CEO, but at the same time, some of the participants could see potential benefits of alternative governance models. Based on the findings of our study, we recommend that: (1) seminary programs include an initial introduction to the importance of Catholic schools for evangelization; (2) a new national model for preparing young and veteran priests for school leadership be developed and implemented; (3) existing best practices for alternative governance models be collated and promulgated; and (4) church leaders and stakeholders determine the best governance models for their schools and then prepare the appropriate people for leadership roles accordingly. [ABSTRACT FROM AUTHOR]

Recognizing that pastors of parishes with a Catholic school play a vital role in Catholic education, and that the seminarians of today will be the parish pastors of tomorrow, this study sought to provide a better understanding of the perceptions held by Catholic seminarians about parish schools. Fourteen seminary students from 12 seminaries and 14 different dioceses from across the United States participated in focus group interviews to discuss their thoughts and perceptions about parish schools. Themes that emerged from focus group discussions included the reinterpretation of the New Evangelization, the understanding of the value of Catholic schools, mixed feelings about leadership of a parish with a school, lack of preparation for school administration, and minimal preparation specific to Catholic schools. Recommendations include the addition of a focus on Catholic schools in new editions of the Program of Priestly Formation (USCCB, 2006) and changes to seminary curricula. [ABSTRACT FROM AUTHOR]

The impact of evolving treatment regimens, airway clearance strategies, and antibiotic combinations on the incidence and prevalence of respiratory infection in cystic fibrosis (CF) in children and adolescents remains unclear. The incidence, prevalence, and prescription trends from 2002 to 2019 with 18,339 airway samples were analysed. Staphylococcus aureus [- 3.86% (95% CI - 5.28-2.43)] showed the largest annual decline in incidence, followed by Haemophilus influenzae [- 3.46% (95% CI - 4.95-1.96)] and Pseudomonas aeruginosa [- 2.80%95% CI (- 4.26-1.34)]. Non-tuberculous mycobacteria and Burkholderia cepacia showed a non-significant increase in incidence. A similar pattern of change in prevalence was observed. No change in trend was observed in infants < 2 years of age. The mean age of the first isolation of S. aureus (p < 0.001), P. aeruginosa (p < 0.001), H. influenza (p < 0.001), Serratia marcescens (p = 0.006) and Aspergillus fumigatus (p = 0.02) have increased. Nebulised amikacin (+ 3.09 ± 2.24 prescription/year, p = 0.003) and colistin (+ 1.95 ± 0.3 prescriptions/year, p = 0.032) were increasingly prescribed, while tobramycin (- 8.46 ± 4.7 prescriptions/year, p < 0.001) showed a decrease in prescription. Dornase alfa and hypertonic saline nebulisation prescription increased by 16.74 ± 4.1 prescriptions/year and 24 ± 4.6 prescriptions/year (p < 0.001). There is a shift in CF among respiratory pathogens and prescriptions which reflects the evolution of cystic fibrosis treatment strategies over time., (© 2024. Crown.)

In developed countries, it is projected that there will be a 70% increase in the number of adults living with Cystic Fibrosis (CF) between 2010 and 2025. This shift in demographics highlights the importance of high-quality transition programmes with developmentally appropriate integrated health care services as the individual moves through adolescence to adulthood. Adolescents living with CF face additional and unique challenges that may have long-term impacts on their health, quality of life and life-expectancy. CF specific issues around socially challenging symptoms, body image, reproductive health and treatment burden differentiate people with CF from their peers and require clinicians to identify and address these issues during the transition process. This review provides an overview of the health, developmental and psychosocial challenges faced by individuals with CF, their guardians and health care teams considering the fundamental components and tools that are required to build a transition programme that can be tailored to suit individual CF clinics., (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)

Patient portals are websites or apps that provide patients with tools to manage healthcare appointments, access their health records, and communicate with clinicians. Patient portals have been demonstrated to be beneficial for improving communication between patients/carers and their healthcare team in a range of health settings. However, there is limited research on the barriers and enablers for implementing patient portals from the perspective of health professionals and healthcare teams, particularly in a paediatric setting. This study aimed to understand healthcare teams' experiences of using a patient portal and, using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework, explore the barriers and enablers to ongoing use. Participants were 11 health professionals participating in the pilot of a patient portal for patients/carers in paediatric care. Data were collected using semi-structured interviews. Analysis of the interview data identified nine themes about implementing a patient portal in paediatric care, all of which aligned with the four constructs of the UTAUT. This study identified that barriers and enablers of the uptake of a patient portal by health professionals in a paediatric context aligned with the UTAUT framework. Value for the patient, improved workflow, and adequate technical and implementation support were highlighted by participants.

Experimental non-human primate models of obesity are induced through the introduction of atypically calorically rich diets. Studies in captive-bred macaques show the development of obesity and diabetes with similar complications to humans including eye and kidney diseases, nerve damage associated with pain and blood vessel damage. Diets differ in outcomes and here we document inflammation of the gastrointestinal tract that can be exacerbated through these dietary interventions. Following baseline physiological evaluation of body composition, Southern pigtail macaques were given a high-fat diet (HFD) for three months. This HFD consisted of lard, grains (including gluten), dairy and fructose that was otherwise omitted from a standard macaque diet (Chow). Physiological parameters were then reassessed before animals were reverted back to standard Chow for a further three months (remission). Consumption of the HFD resulted in food-mediated hypersensitivity marked by chronic weight loss, alopecia, malabsorption, protein-losing enteropathy and gross diffuse intestinal villi atrophy and lamina propria hypertrophy. Physiological changes were more highly pronounced in female macaques suggesting sex-specific differences but could be fully reversed through change of diet. Care should be taken in choosing non-human primate HFD diets for creating experimental models of obesity because they can induce severe food-driven chronic inflammation of the gastrointestinal tract that can eventuate to diet-induced chronic wasting and mortality., Competing Interests: The work presented in our manuscript was partly supported by the National Health and Medical Research Council (NHMRC) of Australia (https://nhmrc.gov.au/) and from a commercial source, NovoNordisk (https://www.novonordisk.com/). These funders did not have any editorial control or role in study design, data collection and analysis, decision to publish, or preparation of the manuscript and does not alter our adherence to PLOS ONE policies on sharing data and materials.

Background: The 'gold standard' test for the indirect determination of pancreatic function status in infants with cystic fibrosis (CF), the 72-hour fecal fat excretion test, is likely to become obsolete in the near future. Alternative indirect pancreatic function tests with sufficient sensitivity and specificity to determine pancreatic phenotype need further evaluation in CF infants., Objective: Evaluation of the clinical utility of both the noninvasive, nonradioactive C-mixed triglyceride (MTG) breath test and fecal elastase-1 (FE1) in comparison with the 72-hour fecal fat assessment in infants with CF., Methods: C-MTG breath test and the monoclonal and polyclonal FE1 assessment in stool was compared with the 72-hour fecal fat assessment in 24 infants with CF. Oral pancreatic enzyme substitution (PERT; if already commenced) was stopped before the tests., Results: Sensitivity rates between 82% and 100% for CF patients with pancreatic insufficiency assessed by both the C-MTG breath test and the FE1 tests proved to be high and promising. The C-MTG breath test (31%-38%) as well as both FE1 tests assessed by the monoclonal (46%-54%) and the polyclonal (45%) ELISA kits, however, showed unacceptably low-sensitivity rates for the detection of pancreatic-sufficient CF patients in the present study., Conclusions: The C-MTG breath test with nondispersive infrared spectroscopy (NDIRS) technique, as well as both FE1 tests, are not alternatives to the fecal fat balance test for the evaluation of pancreatic function in CF infants during the first year of life.

Mutations in the Nkx2-5 gene are a main cause of congenital heart disease. Several studies have addressed the phenotypic consequences of disrupting the Nkx2-5 gene locus, although animal models to date failed to recapitulate the full spectrum of the human disease. Here, we describe a new Nkx2-5 point mutation murine model, akin to its human counterpart disease-generating mutation. Our model fully reproduces the morphological and physiological clinical presentations of the disease and reveals an understudied aspect of Nkx2-5 -driven pathology, a primary right ventricular dysfunction. We further describe the molecular consequences of disrupting the transcriptional network regulated by Nkx2-5 in the heart and show that Nkx2-5 -dependent perturbation of the Wnt signaling pathway promotes heart dysfunction through alteration of cardiomyocyte metabolism. Our data provide mechanistic insights on how Nkx2-5 regulates heart function and metabolism, a link in the study of congenital heart disease, and confirms that our models are the first murine genetic models to our knowledge to present all spectra of clinically relevant adult congenital heart disease phenotypes generated by NKX2-5 mutations in patients., Competing Interests: Conflict of interest: The authors have declared that no conflict of interest exists.

The neuropeptide kisspeptin regulates reproduction by stimulating gonadotropin-releasing hormone (GnRH) neurons via the kisspeptin receptor KISS1R. In addition to GnRH neurons, KISS1R is expressed in other brain areas and peripheral tissues, which suggests that kisspeptin has additional functions beyond reproduction. Here, we studied the energetic and metabolic phenotype in mice lacking kisspeptin signaling (Kiss1r KO mice). Compared with WT littermates, adult Kiss1r KO females displayed dramatically higher BW, leptin levels, and adiposity, along with strikingly impaired glucose tolerance. Conversely, male Kiss1r KO mice had normal BW and glucose regulation. Surprisingly, despite their obesity, Kiss1r KO females ate less than WT females; however, Kiss1r KO females displayed markedly reduced locomotor activity, respiratory rate, and energy expenditure, which were not due to impaired thyroid hormone secretion. The BW and metabolic phenotype in Kiss1r KO females was not solely reflective of absent gonadal estrogen, as chronically ovariectomized Kiss1r KO females developed obesity, hyperleptinemia, reduced metabolism, and glucose intolerance compared with ovariectomized WT females. Our findings demonstrate that in addition to reproduction, kisspeptin signaling influences BW, energy expenditure, and glucose homeostasis in a sexually dimorphic and partially sex steroid-independent manner; therefore, alterations in kisspeptin signaling might contribute, directly or indirectly, to some facets of human obesity, diabetes, or metabolic dysfunction.

In obesity, anorectic responses to leptin are diminished, giving rise to the concept of "leptin resistance." Increased expression of protein tyrosine phosphatase 1B (PTP1B) has been associated with the attenuation of leptin signaling and development of cellular leptin resistance. Here we report that hypothalamic levels of the tyrosine phosphatase TCPTP are also elevated in obesity to attenuate the leptin response. We show that mice that lack TCPTP in neuronal cells have enhanced leptin sensitivity and are resistant to high-fat-diet-induced weight gain and the development of leptin resistance. Also, intracerebroventricular administration of a TCPTP inhibitor enhances leptin signaling and responses in mice. Moreover, the combined deletion of TCPTP and PTP1B in neuronal cells has additive effects in the prevention of diet-induced obesity. Our results identify TCPTP as a critical negative regulator of hypothalamic leptin signaling and causally link elevated TCPTP to the development of cellular leptin resistance in obesity., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Ecological stoichiometry focuses on the balance between multiple nutrient elements in resources and in consumers of those resources. The major consumers of bacteria in aquatic food webs are heterotrophic and mixotrophic nanoflagellates. Despite the importance of this consumer-resource interaction to understanding nutrient dynamics in the aquatic food web, few data are available addressing the element stoichiometry of flagellate consumers. Ochromonas danica, a mixotrophic bacterivore, was used as a model organism to study the relationships among temperature, growth rate and element stoichiometry. Ochromonas danica was grown in chemostats at dilution rates ranging between 0.03 and 0.10 h(-1) and temperatures ranging between 15 and 28 °C. Cells accumulated elements as interactive functions of temperature and growth rate, with the highest element concentrations corresponding to cells grown at a low temperature and high growth rates. The highest concentrations of elements were associated with small cells. Temperature and growth rate affected the element stoichiometry (as C:N, C:P and N:P) of O. danica in a complex manner, but the growth rate had a greater effect on ratios than did temperature., (© 2010 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.)

If messages transmitted to the public, patients and health professionals could be assured of being received, understood and acted on as intended by the senders of messages, there would be little need to focus on communications and feedback. That the physician's office, the healthcare system and the community are littered with messages that 'never got through' attests to the problem of ineffective communications and the absence of effective feedback. Communication theorists, health psychologists and thoughtful health professionals, particularly those working in community hypertension programmes, have developed approaches that improve the probabilities of 'getting the message through'. Theory-based communications with built-in feedback and 'feed-forward' enhance the probabilities of success considerably. This presentation explores these problems using the SMCR model of communication. Differences between linear models and transactional models are discussed. On the assumption that the health message environments of the future will be increasingly complex with highly differentiated target audiences in a rapid paced computer and electronically driven world, 'getting the message through' will become an even greater challenge than in the recent past. Specific steps to change communication approaches in this setting are proposed.

This cross-national comparison study of four health professions is based on review and analysis of professional policy documents and explores the way these selected professions integrate and structure patient education as a professional function. Factors that are internal and external to each of these professions are discussed and compared between the two countries. Professional policy documents related to patient education in nursing, pharmacy, dietetics, and physical therapy are examined in light of changes in dominant concepts of care, changing norms of professional organizations, changes in professional preparation, changes in patient roles, changes in the organization of patient care, and the changes in the health care delivery environment. Differences and similarities between the Netherlands and the United States provide an impetus for developing hypotheses on cross-national developments in patient education and ways for several elements to interact and affect acceptance of and implementation of the patient education function by health professions.

A survey was conducted to determine community health concerns, interests, and perceived health needs. The survey data were used in the selection of health promotion interventions. An index of Concern/Information Need/Participation Willingness (CIP) was developed as a model for planning, implementing, marketing, and evaluating programs.

Problems in collection of uniform data on health education manpower on a continuing basis are discussed. Sources of data on current health education manpower projections for future needs are reviewed. Possible directions for improving manpower planning in this field are cited.

The pathway to achievement of the goal "Health for All by The Year 2000" is lined with good intentions, but one that in the remaining fifteen years of this century may not lead very far. Although development of human resources and support of local autonomy are promoted as the keys to success, in truth much greater attention must be devoted to infrastructures, administration, policies, and data base planning for education and health services. For health education administrators the decisions may be at odds with current economic and social change theory and perhaps at odds with their own values.

This case describes the experiences of one consultant working in Afghanistan, for ten weeks. The case is organized around the consultation cycle, and the problems for which consultation was requested. It raises important questions in terms of how consultants from one culture work in another; how multilateral agencies contract for consultant services - a process which usually prevents the consultant and consultee from interacting around the problems prior to the actual consultation; and how one consultation builds upon the previous consultations, albeit by different consultants. Implicit is the recognition of the need for special preparation in consultation for health educators and for working in cross-cultural contexts.