Myogenic helix-loop-helix (HLH) proteins, such as myogenin and MyoD, can activate muscle-specific transcription when introduced into a variety of nonmuscle cell types. Whereas cells of mesodermal origin are especially permissive to the actions of these myogenic regulators, many other cell types are refractory to myogenic conversion by them. Here we describe a novel homeodomain protein, MHox, that binds an A+T-rich element in the muscle creatine kinase (MCK) enhancer that is essential for muscle-specific transcription and trans-activation by myogenic HLH proteins. MHox is completely restricted to mesodermally derived cell types during embryogenesis and to established cell lines of mesodermal origin. In contrast to most other homeobox genes, MHox expression is excluded from the nervous system, with the highest levels observed in limb bud and visceral arches. In adult mice, MHox is expressed at high levels in skeletal muscle, heart and uterus. The DNA-binding properties and pattern of MHox expression are unique among homeobox genes and suggest a role for MHox as a transcriptional regulator that participates in the establishment of diverse mesodermal cell types.
While previous research has examined the various relationships between fear and learning in K-12 academic settings, the relationship is surprisingly unexplored amongst law students. Using a descriptive qualitative approach, we examine the role fear plays in law students" learning experiences. Through a series of semi-structured interviews a few areas of interest emerged including: fears related to disappointing family members and professors, as well as fears of peer judgment from classmates. The findings of this study demonstrate the unique relationship between the type of fear and how it influences academic motivation within this sample of law students. Based on our findings, we propose suggestions for future research that addresses the potentially detrimental effect of peer judgment on graduate students" academic motivation.
Aims Young people (YP) have the right to be involved in decisions regarding their healthcare and may be able to offer a unique perspective in the selection and recruitment of medical professionals. We aimed to explore the involvement of young people in selection of candidates to Paediatric Specialty Training. In addition to investigating agreement between consultant and YP scores, we also aimed to evaluate feedback from candidates, YP and consultants on the interview participation process. Methods We conducted this pilot service evaluation exercise at our regional interviews for entry to run-through training. Local YP were invited to take part and informed consent was obtained from YP and their parents. YP participated in the structured presentation station, with scoring of 31 candidates by panels of two consultants and two YP. For this pilot exercise YP's scores were not included for ranking and appointment. We conducted agreement analysis of scores (Bland Altman) and collated feedback from 5-level Likert scale questionnaires. Results There was reasonable agreement between consultants and YP with a mean difference of 0.9 (range ±5 points) for presentation scores out of 20. If current consultant scoring were replaced by equally weighted consultant and YP scoring for a single station, 61% (16) of ranked candidates would have seen a change in their ranking. Candidates were deemed unappointable if a minimum score was not achieved; no candidates would have crossed this threshold by the inclusion of YP's scores. Median total score was 117/160 (IQR 23). 83% (43) of feedback respondents believed that YP should be involved in the recruitment of all paediatric trainees. Conclusions YP were motivated to partake in this participation project and could feasibly be involved in the recruitment and selection process. Consultant colleagues were enthusiastic and positive about YP participation. There was reasonable, but not absolute, agreement between consultant and young interviewers such that ranking but not appointability would be affected in this scenario. We intend to extend training for YP with potential involvement in the communication skills station in future. There is genuine potential to implement YP participation widely throughout medical recruitment and selection processes.
Background Family morbidity is a concern in the treatment of paediatric patients but guidance and research lacks reference to siblings. Siblings of chronically sick children are at risk of adverse outcomes if needs are not recognized and met. Positive outcomes are possible with appropriate support. Objective To identify emotional and spiritual needs of children and young people (CYP) with a sibling with a chronic disease. Method A mixed methods study including: validated, UK normed 52-item Kidscreen questionnaire for siblings, proxy version for parents; interviews of each sibling and focus groups drawn from these siblings were recorded, transcribed and subjected to iterative thematic analysis. The setting was Birmingham Children’s Hospital NHSFT, UK. Participants were 16 siblings and 16 parents of children with a chronic rare disease aged 8–16, one specialist nurse. Results The mean of parents’ scores on the questionnaire rated the sibling below the 50th percentile on all ten areas covered. A mean of 34.9 (median 31) for home life shows a significant impact of having a sick child. Siblings consistently rated themselves higher than parents. From the thematic analysis, largely negative consequences of having a sick sibling appeared in all domains. Coping mechanisms were in two main categories: 1. Creative and leisure activities, 2. Family and friends. Discussion and Conclusion Having a chronically unwell sibling negatively impacts global wellbeing, and, specifically in this study, their emotional and spiritual development. Further research will be needed to determine if this can be ameliorated
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