Incorporating health equity in the neurology curriculum: Our experience

BACKGROUND

Social determinants of health (SDoH) are responsible for 80-90% of modifiable contributors to health, yet this material may not be covered in preclinical medical school neuroscience courses.

OBJECTIVE

To describe how topics related to SDoH and inclusion, diversity, equity, anti-racism, and social justice (IDEAS) were incorporated into a preclinical neuroscience course.

METHODS

IDEAS concepts and guided discussions were added to our existing case-based curriculum, and guest speakers were invited to discuss how these concepts are relevant in the field of neurology.

RESULTS

Most students felt that content and discussions were integrated thoughtfully. Students also found it helpful to learn and observe how faculty address these topics in real-world cases.

CONCLUSION

The additional content related to SDoH and IDEAS is feasible. Faculty with or without expertise in IDEAS concepts were able to utilize these cases and generate discussion without detracting from the neuroscience course material.

Cutting edge: differential signaling requirements for activation of assembled cyclin D3-cdk4 complexes in B-1 and B-2 lymphocyte subsets

B-1 lymphocytes represent a distinct B cell subset with unusual mitogenic responses. PMA alone promotes proliferation in B-1 cells, but not in splenic B-2 cells. Although cyclin D2-cyclin-dependent kinase 4 (cdk4) complexes mediate early retinoblastoma gene product (pRb) phosphorylation in B-1 cells, the transient nature of their accumulation cannot account for the continued increase in pRb phosphorylation, which is maximal at 24 h. We show herein that PMA promotes the accumulation of functional cyclin D3-cdk4 complexes in B-1 cells following loss of cyclin D2. PMA also induces accumulation of cyclin D3-cdk4 complexes in B-2 cells; however, these complexes do not phosphorylate pRb. Thus, PMA is sufficient to induce synthesis and assembly of cyclin D3-cdk4 complexes in B-1 and B-2 cells; however, PMA triggers cyclin D3-cdk4 activation only in B-1 cells. These results reveal a novel regulatory step that controls activation of cyclin D3-cdk4 complexes whose function segregates differentially in B cell subsets.

A multidisciplinary approach to cardiac rehabilitation

As health care professionals we believe rehabilitation and patient education should commence on admission and continue through to discharge. Ideally it should be started from birth, with education by the family, school, GPs and well person clinics. This should include family screening an awareness of health and factors which may affect this. When patients develop angina, support should be given so that they can control the effects more adequately and reduce potential risk factors. There should be no exclusion criteria for patients accepted on these programmes as those who would probably be excluded are those who would require rehabilitation the most. Every individual can participate in discussion and any form of exercise can be tailored to meet the individual's needs. Many benefits have been mentioned, but the most important one is the improved quality of life for the patient and her or his family. Cardiac rehabilitation programmes and self-help groups may provide additional support to the patient and family during convalescence. Group programmes through their dynamics help to overcome feelings of isolation. Patients feel they gain support from their peer-group and they in turn can help each other overcome residual symptoms and practical difficulties. This 'social' rehabilitation is often the most beneficial aspect of the course; the group really helps them succeed. Rehabilitation must be accepted as part of the treatment and not a luxury for a few patients. This is a very exciting time when interest in this area is developing and research is examining the quality of life. We need to evaluate continually and undertake research to improve nursing practice.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of oestradiol-17beta, oestradiol benzoate and the synthetic oestrogen RU 2858 on sexual differentiation in the neonatal female rat

Groups of neonatal female rats were treated for the first 5 days of life with oestradiol-17beta, oestradiol benzoate or a synthetic oestrogen, 11beta-methoxy-17-ethynyl-1,3,5(10)-oestratriene-3,17beta-diol (RU 2858), in daily doses ranging from 0-5 to 1000 ng. Oestradiol-17beta had no effect on adult ovarian cyclicity or sexual receptivity after ovariectomy and oestrogen+ progesterone treatment. Ovarian cyclicity was prevented by 100 ng or more oestradiol benzoate/day, and by all doses of RU 2858. Only rats receiving 50 ng oestradiol benzoate/day or 0-5 ng RU 2858/day showed normal receptivity. The defeminizing action of RU 2858 was at least 100 times greater than that of oestradiol benzoate; it is suggested that this greater potency is due to the low affinity of RU 2858 for the oestradiol-binding protein in the plasma of neonatal rats. These results indicate that defeminization of the neonatal rat brain can be induced by physiological amounts of oestrogen, and are discussed with reference to the action of testosterone.