The Need for an Economic Stimulus Package

This policy proposal outlines a substantial economic stimulus package needed to address the recent downturn in the U.S. economy. This stimulus package details steps to create jobs, provide economic support and lessen the effects of a weakening economy

Slow-Motion Recession: What Congress Can Do to Help

This report presents several proposals designed to address the nation’s current economic slowdown. To blunt the effects of this downturn and provide immediate relief, the authors suggest a second stimulus package. Proposals for the package include an expanded tax credit for homes and businesses to make energy conserving renovations, subsidies for state and local governments to reduce fares on public transportation, matching grants to state and local governments to invest in energy conserving renovations, grants to state and local governments so that they will not be forced to raise taxes and/or layoff workers and cut services in the middle of a downturn, additional payments to low- and moderate-income households through programs such as Food Stamps, School Lunches and the Low Income Heating and Energy Assistance Program to make it easier for families to cope with rising food and energy prices, modernization of the unemployment insurance system and further extension of the benefit period. To promote continued, sustained growth, the paper suggests policies that will require restructuring the U.S. economy to protect homeowners, reel in financial markets, and to restore some balance to our work and family commitments.fiscal stimulus, economic stimulus, recession, deficit spending

‘Hidden habitus’: a qualitative study of socio-ecological influences on drinking practices and social identity in mid-adolescence

This study explored mid-adolescents’ views and experiences of socio-ecological influences on their drinking practices in order to help inform the development of interventions to reduce alcohol-related risk. We conducted 31 in-depth interviews with young people aged 13–17 in North East England. Verbatim interview transcripts and field notes were coded systematically and analysed thematically, following the principles of constant comparison. We adopted Bourdieu’s idea of social game-playing and elements of his conceptual toolkit (particularly habitus, capital and field) during analysis. Analysis yielded three intersecting themes: (1) ‘drinking etiquette’: conveying taste and disgust; (2) ‘playing the drinking game’: demonstrating cultural competency; (3) ‘hidden habitus’—the role of alcohol marketing. Our work demonstrates that there is a nexus of influential factors which come together to help shape and reinforce mid-adolescents’ behaviour, norms and values in relation to alcohol consumption. Drinking practices are not just formed by friendships and family traditions, these are also subject to wider cultural shaping including by the alcohol industry which can encourage brand identification, and gear specific products to add ‘distinction’. However young people are not inactive players and they use aspects of capital and social games to help cement their identity and present themselves in particular ways which in turn are influenced by age, gender and social status. Guided by promising work in the tobacco field, interventions which focus on critical awareness of the framing of alcohol products by key stakeholders, such as policymakers, commercial industry and public health professionals, and by wider society may facilitate behaviour change among young people

Design and Evaluation of a Novel Ankle Joint for an Ankle Foot Orthosis for Individuals with Drop-Foot

Individuals who have had a stroke often ambulate with an ankle foot orthosis (AFO) to treat drop-foot, a common impairment preventing active ankle dorsiflexion. AFOs limit ankle plantarflexion or drop-foot, but also restrict ankle motion that introduces additional gait pathologies during ambulation. The goal of this study was to design a mechanical ankle joint for an articulated thermoplastic AFO to permit enhanced motion during stance. This novel ankle joint operated in two stages: 1) locked during swing to prevent drop-foot and 2) unlocked during stance to allow motion. This novel ankle joint was first tested with able-bodied subjects to ensure device function and safety, subsequent testing was conducted with post-stroke subjects to determine whether the novel design contributed to functional improvements during walking. Three able-bodied (23-26 years) and three post-stroke individuals (52-67 years) were recruited to complete custom AFO casting, fitting, and testing sessions with conventional and novel orthotic ankle joints. Testing included overground and variable slope treadmill walking trials. These gait analyses incorporated motion capture and kinetic data to calculate spatiotemporal, kinematic, and joint moment data. A survey was administered after testing to determine subject perception of the novel ankle joint in terms of comfort, walking performance, and perceived exertion. Paired t-tests were conducted to identify significant differences between orthotic ankle joint conditions.Significant differences between ankle joint conditions were observed for stance duration, step length, and ankle plantarflexion during swing. Stance duration and step length increased for the paretic limb, and corresponding improved inter-limb symmetry for level and non-level terrain. Ankle plantarflexion during swing with the novel ankle joint was controlled, providing adequate foot clearance and increased ankle range of motion during early stance. These improvements in ankle mobility, however, did not contribute to consistent improvements in hip kinematics, nor significant differences in knee and hip kinetics.Design refinement is recommended to support joint tuning and accommodate greater variation in spring stiffnesses. This novel orthotic ankle joint demonstrates promise and clinical potential to treat post-stroke individuals with drop-foot

Diverse chemotypes disrupt ion homeostasis in the malaria parasite

The antimalarial spiroindolones disrupt Plasmodium falciparumNa+ regulation and induce an alkalinization of the parasite cytosol. It has been proposed that they do so by inhibiting PfATP4, a parasite plasma membrane P-type ATPase postulated to export Na

Oral health problems and mortality

AbstractBackground/purposePrevious studies have shown the relationship between individual oral health conditions and mortality; however, the relationship between mortality and multiple oral health conditions has not been examined. This study investigates the link between individual oral health problems and oral comorbidity and mortality risk.Materials and methodsData are derived from the National Health and Nutrition Examination Survey 1999–2004, which is linked to the National Death Index for mortality follow-up through 2006. We estimated the risk of mortality among people with three individual oral health conditions—tooth loss, root caries, and periodontitis as well as with oral comorbidity—or having all three conditions.ResultsSignificant tooth loss, root caries, and periodontal disease were associated with increased odds of dying. The relationship between oral health conditions and mortality disappeared when controlling for sociodemographic, health, and/or health behavioral indicators. Having multiple oral health problems was associated with an even higher rate of mortality.ConclusionIndividual oral health conditions—tooth loss, root caries, and periodontal disease—were not related to mortality when sociodemographic, health, and/or health behavioral factors were considered, and there was no differential pattern between the three conditions. Multiple oral health problems were associated with a higher risk of dying

Molecular Mechanisms for Drug Hypersensitivity Induced by the Malaria Parasite's Chloroquine Resistance Transporter

Mutations in the Plasmodium falciparum ‘chloroquine resistance transporter’ (PfCRT) confer resistance to chloroquine (CQ) and related antimalarials by enabling the protein to transportthese drugs away from their targets within the parasite’s digestive vacuole (DV). However, CQ resistance-conferring isoforms of PfCRT (PfCRTCQR) also render the parasite hypersensitive to a subset of structurally-diverse pharmacons. Moreover, mutations in PfCRTCQR that suppress the parasite’s hypersensitivity to these molecules simultaneously reinstate its sensitivity to CQ and related drugs. We sought to understand these phenomena by characterizing the functions of PfCRTCQR isoforms that cause the parasite to become hypersensitive to the antimalarial quinine or the antiviral amantadine. We achieved this by measuring the abilities of these proteins to transport CQ, quinine, and amantadine when expressed in Xenopus oocytes and complemented this work with assays that detect the drug transport activity of PfCRT in its native environment within the parasite. Here we describe two mechanistic explanations for PfCRT-induced drug hypersensitivity. First, we show that quinine, which normally accumulates inside the DV and therewithin exerts its antimalarial effect, binds extremely tightly to the substrate-binding site of certain isoforms of PfCRTCQR. By doing so it likely blocks the normal physiological function of the protein, which is essential for the parasite’s survival, and the drug thereby gains an additional killing effect. In the second scenario, we show that although amantadine also sequesters within the DV, the parasite’s hypersensitivity to this drug arises from the PfCRTCQR-mediated transport of amantadine from the DV into the cytosol, where it can better access its antimalarial target. In both cases, the mutations that suppress hypersensitivity also abrogate the ability of PfCRTCQR to transport CQ, thus explaining why rescue from hypersensitivity restores the parasite’s sensitivity to this antimalarial. These insights provide a foundation for understanding clinically-relevant observations of inverse drug susceptibilities in the malaria parasite

Working out of the ‘toolbox’: an exploratory study with complementary therapists in acute cancer care

Aims: The aim of this research was to explore and capture therapists’ experiences of and preparation for working with patients in an acute cancer care setting. Method: Semi structured interviews with therapists (n=18) in an acute cancer hospital in the North West of England. The interviews were transcribed and analysed using thematic coding. Results: Key themes identified included; the need for a ‘tool box’ that goes beyond initial training, building confidence with adapting these new skills in practice, helping patients to become empowered, the need to support carers, research evidence and resources issues, and the role of supervision. Conclusion: This study was limited by being set in a single acute cancer site. Therapists valued having a ‘tool box’ but needed confidence and support to navigate the challenges of clinical practice.The authors would like to acknowledge the support of ‘Walk the Walk’ Charity, who help fund the complementary therapy services in the Radiotherapy and Chemotherapy Departments

The Human Tissue-Biomaterial Interface : A Role for PPARγ-Dependent Glucocorticoid Receptor Activation in Regulating the CD163(+) M2 Macrophage Phenotype

In vivo studies of implanted acellular biological scaffolds in experimental animals have shown constructive remodeling mediated by anti-inflammatory macrophages. Little is known about the human macrophage response to such biomaterials, or the nature of the signaling mechanisms that govern the macrophage phenotype in this environment. The cellular events at the interface of a tissue and implanted decellularized biomaterial were examined by establishing a novel ex vivo tissue culture model in which surgically excised human urinary tract tissue was combined with porcine acellular bladder matrix (PABM). Evaluation of the tissue-biomaterial interface showed a time-dependent infiltration of the biomaterial by CD68(+) CD80(-) macrophages. The migration of CD68(+) cells from the tissue to the interface was accompanied by maturation to a CD163(hi) phenotype, suggesting that factor(s) associated with the biomaterial or the wound edge was/were responsible for the active recruitment and polarization of local macrophages. Glucocorticoid receptor (GR) and peroxisome proliferator activated receptor gamma (PPARγ) signaling was investigated as candidate pathways for integrating inflammatory responses; both showed intense nuclear labeling in interface macrophages. GR and PPARγ activation polarized peripheral blood-derived macrophages from a default M1 (CD80(+)) toward an M2 (CD163(+)) phenotype, but PPARγ signaling predominated, as its antagonism blocked any GR-mediated effect. Seeding on PABM was effective at polarizing peripheral blood-derived macrophages from a default CD80(+) phenotype on glass to a CD80(-) phenotype, with intense nuclear localization of PPARγ. These results endorse in vivo observations that the infiltration of decellularized biological scaffolds, exemplified here by PABM, is pioneered by macrophages. Thus, it appears that natural factors present in PABM are involved in the active recruitment and polarization of macrophages to a CD163(+) phenotype, with activation of PPARγ identified as the candidate pathway. The harnessing of these natural matrix-associated factors may be useful in enhancing the integration of synthetic and other natural biomaterials by polarizing macrophage activation toward an M2 regulatory phenotype