Integrating Health Literacy Questions into a Statewide Behavioral Risk Factor Surveillance System (BRFSS) Questionnaire

Objectives. The purpose of this pilot study was to evaluate the feasibility of adding health literacy questions to a state health assessment questionnaire. Methods. Researchers conducted a series of telephone interviews (N = 20) to test the telephone administration of three health literacy screening questions with a convenience sample. Feedback obtained during the telephone interviews was used to revise the questions for clarity. The revised questions were proposed as an addition to the Kansas Behavioral Risk Factor Surveillance System (BRFSS). Results. Pilot data included minor modifications to the language of the questions to broaden their interpretation outside of a hospital setting. Most participants (90%, n = 18) had adequate health literacy. The proposed questions were approved for addition to the BRFSS questionnaire. Prompts were added to a telephone script to aid BRFSS survey administrators. Conclusion. As one of the first statewide health literacy assessments, this study has demonstrated one method for collecting baseline data. This new methodology has the potential to impact both patient care and broad public health efforts

Using the March of Dimes "Becoming a Mom" Prenatal Program to Improve Maternal Attitudes and Knowledge

BACKGROUND: Premature birth, low birth weight, birth defects, and Sudden Infant Death Syndrome were identified as issues contributing to infant mortality in Kansas by the state’s Blue Ribbon Panel. The March of Dimes Becoming a Mom (BAM) prenatal program was implemented in four counties identified with high infant mortality rates and significant birth numbers (Geary, Saline, Sedgwick, and Shawnee) by the Kansas Blue Ribbon Panel. The purpose of this study was to identify the changes in prenatal attitudes, knowledge, and health outcomes among BAM program participants. METHODS: A collaborative community-based model incorporating multidisciplinary teams was created to address the health disparity gap in birth outcomes. Patients participated in multiple prenatal education sessions using a curriculum developed by the March of Dimes. A pre-/post-test design was implemented for the prenatal sessions. Changes in attitudes were assessed using descriptive statistics. Paired t-tests were used to assess the difference in knowledge questions from pre- and post-tests. Health outcomes were analyzed using descriptive statistics. RESULTS: Participants were 69% White, 87% spoke English, 64% were under age 26, 41% were employed full time, 45% had some high school or had a diploma, 39% had Medicaid, and 49% were enrolled in WIC (N=114). Participants demonstrated a statistically significant increase in knowledge among 14 out of 32 questions including: identifying signs of preterm labor, what to do during preterm labor, postpartum symptoms, and baby sleep position. There were also changes in prenatal attitudes including: need for prenatal care as soon as possible, continuing prenatal care when feeling healthy and not smoking during pregnancy. Relative frequencies were tabulated for week of delivery, infant birth weight, type of delivery, and presence of maternal and infant medical conditions. CONCLUSION: The March of Dimes BAM program participants reported improvements in prenatal knowledge. The BAM program can improve maternal knowledge through a community-based collaborative model of care. The combined prenatal education program with quality prenatal care can result in better maternal and child health outcomes

A to Z of polymorphs related by proton transfer

The occurrence of tautomeric polymorphism in the Cambridge Structural Database (CSD) was established to be very rare in a previous study by A. J. Cruz-Cabeza and C. R. Groom (CrystEngComm, 2011, 13, 93). A decade has now elapsed and the CSD has seen a significant increase in its total number of crystal structures, useful CSD subsets have been introduced and the CSD Python API has been developed to allow for complex data mining. Given this, we wanted to revisit tautomeric polymorphs in the CSD alongside other polymorphs related by proton transfer and compare these results with those from an in-house pharmaceutical database in order to assess their prevalence and significance for pharmaceuticals. From A (amine–imine tautomeric polymorphs) to Z (zwitterionic polymorphs), here we study different types of polymorphs related by proton-transfer in the CSD, the CSD drug subset (DrugCSD), the single component drug subset of the CSD (SDrugCSD), and the GSK small molecule crystal structure database (GSD). First, we assess the potential of compounds to exist as tautomers. Whilst 51% of compounds in the CSD are capable of tautomerism, this number increases to 73% and 70% for the SDrugCSD and the GSD respectively. Tautomerism potential is, thus, more prevalent in pharmaceuticals than in common organic compounds in the CSD. Second, in mining the CSD we identify a total of 95 families of polymorphs related by proton transfer which can then be classified into six different categories depending on the type of proton transfer observed and the ionisation of species involved. The most common of such category is that of tautomeric polymorphs followed by zwitterionic polymorphs. The rarest type of proton transfer polymorphs is that of multi-zwitterionic polymorphs where two different zwitterions of the same compound are found in two different crystal structures. Overall, 3% of polymorphic compositions in the DrugCSD are found to be related by proton transfer which, although not very common, is of relevance to pharmaceuticals and drug development due to the potential impact on physical properties. Specific examples of each of the categories are discussed with calculations of lattice energies presented and consideration of ΔpKa values and likelihood of proton transfer and ionisation

An amphipathic helix enables septins to sense micrometer-scale membrane curvature

© The Authors, 2019. This article is distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 International License. The definitive version was published in Journal of Cell Biology (2019), doi:10.1083/jcb.201807211.Cell shape is well described by membrane curvature. Septins are filament-forming, GTP-binding proteins that assemble on positive, micrometer-scale curvatures. Here, we examine the molecular basis of curvature sensing by septins. We show that differences in affinity and the number of binding sites drive curvature-specific adsorption of septins. Moreover, we find septin assembly onto curved membranes is cooperative and show that geometry influences higher-order arrangement of septin filaments. Although septins must form polymers to stay associated with membranes, septin filaments do not have to span micrometers in length to sense curvature, as we find that single-septin complexes have curvature-dependent association rates. We trace this ability to an amphipathic helix (AH) located on the C-terminus of Cdc12. The AH domain is necessary and sufficient for curvature sensing both in vitro and in vivo. These data show that curvature sensing by septins operates at much smaller length scales than the micrometer curvatures being detected.We thank the Gladfelter laboratory and Danny Lew for useful discussions, Matthias Garten for ideas in setting up the rod assay, and the University of North Carolina EM facility (Victoria Madden and Kristen White) for support with scanning electron microscope. This work was supported by a Howard Hughes Medical Institute Faculty Scholars award to A.S. Gladfelter, and K.S. Cannon was supported in part by a grant from the National Institute of General Medical Sciences under award T32 GM119999.2019-07-0

Euthanasia: agreeing to disagree?

In discussions about the legalisation of active, voluntary euthanasia it is sometimes claimed that what should happen in a liberal society is that the two sides in the debate “agree to disagree”. This paper explores what is entailed by agreeing to disagree and shows that this is considerably more complicated than what is usually believed to be the case. Agreeing to disagree is philosophically problematic and will often lead to an unstable compromise

Interpreting Sequence-Levenshtein distance for determining error type and frequency between two embedded sequences of equal length

Levenshtein distance is a commonly used edit distance metric, typically applied in language processing, and to a lesser extent, in molecular biology analysis. Biological nucleic acid sequences are often embedded in longer sequences and are subject to insertion and deletion errors that introduce frameshift during sequencing. These frameshift errors are due to string context and should not be counted as true biological errors. Sequence-Levenshtein distance is a modification to Levenshtein distance that is permissive of frameshift error without additional penalty. However, in a biological context Levenshtein distance needs to accommodate both frameshift and weighted errors, which Sequence-Levenshtein distance cannot do. Errors are weighted when they are associated with a numerical cost that corresponds to their frequency of appearance. Here, we describe a modification that allows the use of Levenshtein distance and Sequence-Levenshtein distance to appropriately accommodate penalty-free frameshift between embedded sequences and correctly weight specific error types.Comment: 10 pages, 8 figure

Examining Communication and Patient Recall in a Family Medicine Residency

Background. Understanding key aspects of effective physician-patient communication could benefit residency education and improve patient comprehension of health information. Discrepancies between what physicians say and what patients understand can reduce quality of care (e.g., patient adherence and satisfaction), making it imperative to know when gaps in patient understanding exist. The objective of this study was to identify residents’ efforts to assess patient understanding and the degree to which patients recalled information and instructions provided in the medical encounter. Methods. Residents and patients were observed in routine medical encounters in a Midwestern family medicine residency center. Patients were surveyed immediately following the encounter for recall of information and recommendations from the encounter, satisfaction with physician communication, and health literacy. Results. A total of 21 physician-patient encounters were observed. An inverse relationship was noted (Spearman’s rho = -0.43, N = 21, p = 0.05) between number of topics discussed during the encounter and the percentage of information recalled. Conclusions. Patient recall was related inversely to the number of topics covered by resident physicians. These results challenge physicians and medical educators to study and employ further those elements of physician-patient communication that enhance patient recall and understanding

Oklahoma economic pulse survey results

The Oklahoma Cooperative Extension Service periodically issues revisions to its publications. The most current edition is made available. For access to an earlier edition, if available for this title, please contact the Oklahoma State University Library Archives by email at [email protected] or by phone at 405-744-6311

Pilot Testing Behavior Therapy for Chronic Tic Disorders in Neurology and Developmental Pediatrics Clinics

Comprehensive Behavioral Intervention for Tics (CBIT) is an efficacious treatment with limited regional availability. As neurology and pediatric clinics are often the first point of therapeutic contact for individuals with tics, the present study assessed preliminary treatment response, acceptability, and feasibility of an abbreviated version, modified for child neurology and developmental pediatrics clinics. Fourteen youth (9-17) with Tourette disorder across 2 child neurology clinics and one developmental pediatrics clinic participated in a small case series. Clinician-rated tic severity (Yale Global Tic Severity Scale) decreased from pre- to posttreatment, z = –2.0, P \u3c .05, r = –.48, as did tic-related impairment, z = –2.4, P \u3c .05, r = –.57. Five of the 9 completers (56%) were classified as treatment responders. Satisfaction ratings were high, and therapeutic alliance ratings were moderately high. Results provide guidance for refinement of this modified CBIT protocol

The Australia-modified Karnofsky Performance Status (AKPS) scale: a revised scale for contemporary palliative care clinical practice [ISRCTN81117481]

© 2005 Abernethy et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background : The Karnofsky Performance Status (KPS) is a gold standard scale. The Thorne-modified KPS (TKPS) focuses on community-based care and has been shown to be more relevant to palliative care settings than the original KPS. The Australia-modified KPS (AKPS) blends KPS and TKPS to accommodate any setting of care. Methods : Performance status was measured using all three scales for palliative care patients enrolled in a randomized controlled trial in South Australia. Care occurred in a range of settings. Survival was defined from enrollment to death. Results : Ratings were collected at 1600 timepoints for 306 participants. The median score on all scales was 60. KPS and AKPS agreed in 87% of ratings; 79% of disagreements occurred within 1 level on the 11-level scales. KPS and TKPS agreed in 76% of ratings; 85% of disagreements occurred within one level. AKPS and TKPS agreed in 85% of ratings; 87% of disagreements were within one level. Strongest agreement occurred at the highest levels (70–90), with greatest disagreement at lower levels (≤40). Kappa coefficients for agreement were KPS-TKPS 0.71, KPS-AKPS 0.84, and AKPS-TKPS 0.82 (all p < 0.001). Spearman correlations with survival were KPS 0.26, TKPS 0.27 and AKPS 0.26 (all p < 0.001). AKPS was most predictive of survival at the lower range of the scale. All had longitudinal test-retest validity. Face validity was greatest for the AKPS. Conclusion : The AKPS is a useful modification of the KPS that is more appropriate for clinical settings that include multiple venues of care such as palliative care