Feasibility Test of the MedaCube

Poor adherence is a significant barrier to achieve better patient outcomes. Rates of non-adherence approach 40% resulting in 10% of all emergency department visits and 23% of admissions into skilled nursing facilities. Many factors contribute to medication non-adherence including psychological and memory disorders, aging and pill burden. The MedaCube is a medication management system intended to help solve unintentional medication non-adherence. The device is designed to dispense scheduled and as-needed oral medications. The MedaCube provides audio and visual prompts alerting subjects to administer their medications. Caregivers receive notification of missed doses, late doses and refill requests. The null hypothesis is that use of the MedaCube results in no difference in medication adherence when compared with six month prior adherence in individual subjects

The Role of Perception in Developing Healthy Lifestyles and Community Engagement

Background: The Cobb and Douglas Public Health Department and the Cobb2020 partnership, sponsored by the Mobilizing for Action through Planning and Partnering program, facilitated six focus groups in Cobb County to ascertain residents’ perceptions of healthy behaviors. The purpose of the research was to assist in the development of programs to increase healthy behaviors. Methods: Purposive sampling was used to choose fifty-eight participants, who were divided into six groups in different geographic locations. The focus group questions concerned healthy living, health communications, and community health. Qualitative data analysis techniques were used to generate themes and categories across and within groups. Results: Six themes emerged: 1) need for education; 2) healthy food choices; 3) access to healthcare; 4) trust in health care providers; 5) affordable healthcare; and 6) need for local resources. The results show how community members’ perceptions regarding: a) policies that affect health, b) environments that promote healthier choices, and c) systems that allow individuals to be health consumers influence healthy living and community engagement. Other findings note different perceptions between those with and without health insurance. In addition, socio-economic status and ethnicity were seen as factors related to the perceptions of participants. Conclusions: The findings of this study informed a comprehensive, county-wide Community Health Improvement Plan. As a result of these studies, Cobb & Douglas Public Health established, as two chronic disease prevention interventions, the Cobb2020 Farm Fresh Market and, in the City of Kennesaw, the 100% Tobacco Free Parks and Cemeteries policy

The beta-decay of 22Al

In an experiment performed at the LISE3 facility of GANIL, we studied the decay of 22Al produced by the fragmentation of a 36Ar primary beam. A beta-decay half-life of 91.1 +- 0.5 ms was measured. The beta-delayed one- and two-proton emission as well as beta-alpha and beta-delayed gamma decays were measured and allowed us to establish a partial decay scheme for this nucleus. New levels were determined in the daughter nucleus 22Mg. The comparison with model calculations strongly favours a spin-parity of 4+ for the ground state of 22Al

GABAA receptors can initiate the formation of functional inhibitory GABAergic synapses.

The mechanisms that underlie the selection of an inhibitory GABAergic axon's postsynaptic targets and the formation of the first contacts are currently unknown. To determine whether expression of GABAA receptors (GABAA Rs) themselves - the essential functional postsynaptic components of GABAergic synapses - can be sufficient to initiate formation of synaptic contacts, a novel co-culture system was devised. In this system, the presynaptic GABAergic axons originated from embryonic rat basal ganglia medium spiny neurones, whereas their most prevalent postsynaptic targets, i.e. α1/β2/γ2-GABAA Rs, were expressed constitutively in a stably transfected human embryonic kidney 293 (HEK293) cell line. The first synapse-like contacts in these co-cultures were detected by colocalization of presynaptic and postsynaptic markers within 2 h. The number of contacts reached a plateau at 24 h. These contacts were stable, as assessed by live cell imaging; they were active, as determined by uptake of a fluorescently labelled synaptotagmin vesicle-luminal domain-specific antibody; and they supported spontaneous and action potential-driven postsynaptic GABAergic currents. Ultrastructural analysis confirmed the presence of characteristics typical of active synapses. Synapse formation was not observed with control or N-methyl-d-aspartate receptor-expressing HEK293 cells. A prominent increase in synapse formation and strength was observed when neuroligin-2 was co-expressed with GABAA Rs, suggesting a cooperative relationship between these proteins. Thus, in addition to fulfilling an essential functional role, postsynaptic GABAA Rs can promote the adhesion of inhibitory axons and the development of functional synapses

Establishing the values for patient engagement (PE) in health-related quality of life (HRQoL) research: an international, multiple-stakeholder perspective

PurposeActive patient engagement is increasingly viewed as essential to ensuring that patient-driven perspectives are considered throughout the research process. However, guidance for patient engagement (PE) in HRQoL research does not exist, the evidence-base for practice is limited, and we know relatively little about underpinning values that can impact on PE practice. This is the first study to explore the values that should underpin PE in contemporary HRQoL research to help inform future good practice guidance. MethodsA modified ‘World Café’ was hosted as a collaborative activity between patient partners, clinicians and researchers: self-nominated conference delegates participated in group discussions to explore values associated with the conduct and consequences of PE. Values were captured via post-it notes and by nominated note-takers. Data were thematically analysed: emergent themes were coded and agreement checked. Association between emergent themes, values and the Public Involvement Impact Assessment Framework were explored. ResultsEighty participants, including 12 patient partners, participated in the 90-min event. Three core values were defined: (1) building relationships; (2) improving research quality and impact; and (3) developing best practice. Participants valued the importance of building genuine, collaborative and deliberative relationships—underpinned by honesty, respect, co-learning and equity—and the impact of effective PE on research quality and relevance. Conclusions An explicit statement of values seeks to align all stakeholders on the purpose, practice and credibility of PE activities. An innovative, flexible and transparent research environment was valued as essential to developing a trustworthy evidence-base with which to underpin future guidance for good PE practice.Peer reviewe

Evaluation Results of an Innovative Pilot Program to Increase Access to Fresh Fruits and Vegetables in Cobb County, GA

Background: This abstract describes a public health practice initiative called the Farm Fresh Market (FFM) and presented pilot evaluation results. Methods: The FFM, developed by Cobb and Douglas Public Health, the McCleskey-East Cobb Family YMCA, and Cobb2020, sold low-cost fruits and vegetables to families living in the 30168 zip code of Austell, Georgia. The evaluation focused on documenting to what extent the FFM reached its intended population and increased perceived access to fresh fruits and vegetables among customers. A convenience sample of 100 returning FFM customers completed self-administered, written intercept surveys at the end of the 2014 market season. Results: The market served customers from a range of socioeconomic backgrounds. Most customers strongly agreed that the FFM made it easier (69%) and less expensive (79%) for them to buy fresh fruits and vegetables and easier for them (63%) and their families (64%) to eat a healthy diet. Most customers reported that they ate more vegetables (65%) and fruit (55%) as a result of shopping at the FFM and reported high levels of satisfaction with all aspects of the FFM. Conclusions: The results suggest that the FFM served customers from the local area and that the FFM may have increased perceived access to healthy food options among customers. Community-level interventions to increase access to healthy foods may play an important role in chronic disease prevention

MHC class I chain-related protein A shedding in chronic HIV-1 infection is associated with profound NK cell dysfunction

Natural killer (NK) cells play a critical role in host defense against viral infections. However chronic HIV-1 infection is associated with an accumulation of dysfunctional NK cells, that poorly control viral replication. The underlying mechanisms for this NK cell mediated dysfunction are not understood. Certain tumors evade NK cell mediated detection by dampening NK cell activity through the downregulation of NKG2D, via the release of soluble NKG2D-ligands, resulting in a potent suppression of NK cell function. Here we show that chronic HIV-1 infection is associated with a specific defect in NKG2D-mediated NK cell activation, due to reduced expression and transcription of NKG2D. Reduced NKG2D expression was associated with elevated levels of the soluble form of the NKG2D-ligand, MICA, in patient sera, likely released by HIV+CD4+ T cells. Thus, like tumors, HIV-1 may indirectly suppress NK cell recognition of HIV-1-infected CD4+ T cells by enhancing NKG2D-ligand secretion into the serum resulting in a profound impairment of NK cell function

Social Constructivism and Case-Writing for an Integrated Curriculum

Case-writing within an integrated, systems-based health professions education curriculum presents many unique challenges. Specifically, case-writing in this context must consider integration of multidisciplinary learning objectives and synthesis of biomedical and clinical sciences. Establishing an effective process for content integration and determining who should be involved in the case-writing process can be a daunting task and this specific context requires a new model for effective casewriting. This paper provides a model for the cycle of case development, implementation, evaluation and modification in an integrated, systems-based health professions curriculum. We highlight how this collaborative case-writing model parallels the social constructivist approach promoted by the problem-based learning process in which our students engage

THP-1 macrophage cholesterol efflux is impaired by palmitoleate through Akt activation.

Lipoprotein lipase (LPL) is upregulated in atherosclerotic lesions and it may promote the progression of atherosclerosis, but the mechanisms behind this process are not completely understood. We previously showed that the phosphorylation of Akt within THP-1 macrophages is increased in response to the lipid hydrolysis products generated by LPL from total lipoproteins. Notably, the free fatty acid (FFA) component was responsible for this effect. In the present study, we aimed to reveal more detail as to how the FFA component may affect Akt signalling. We show that the phosphorylation of Akt within THP-1 macrophages increases with total FFA concentration and that phosphorylation is elevated up to 18 hours. We further show that specifically the palmitoleate component of the total FFA affects Akt phosphorylation. This is tied with changes to the levels of select molecular species of phosphoinositides. We further show that the total FFA component, and specifically palmitoleate, reduces apolipoprotein A-I-mediated cholesterol efflux, and that the reduction can be reversed in the presence of the Akt inhibitor MK-2206. Overall, our data support a negative role for the FFA component of lipoprotein hydrolysis products generated by LPL, by impairing macrophage cholesterol efflux via Akt activation

Prospectus, November 19, 1986

https://spark.parkland.edu/prospectus_1986/1030/thumbnail.jp