State Prescription Drug Price Web Sites: How Useful to Consumers?

Compares ten sites and identifies key limitations due to data omissions, gaps between insured and uninsured consumers, and varied program implementation. Presents alternative policy options such as requiring price lists from pharmacies

Awareness and Use of Non-conventional Tobacco Products Among U.S. Students, 2012

BackgroundIncreasing diversity of the tobacco product landscape, including electronic cigarettes (e-cigarettes), hookah, snus, and dissolvable tobacco products (dissolvables), raises concerns about the public health impact of these non-conventional tobacco products among youth.PurposeThis study assessed awareness, ever use, and current use of non-conventional tobacco products among U.S. students in 2012, overall and by demographic and tobacco use characteristics.MethodsData from the 2012 National Youth Tobacco Survey, a nationally representative survey of U.S. middle and high school students, were analyzed in 2013. Prevalence of awareness, ever use, and current use of e-cigarettes, hookah, snus, and dissolvables were calculated overall and by sex, school level, race/ethnicity, and conventional tobacco product use, including cigarettes, cigars, or smokeless tobacco (chewing tobacco, snuff, or dip).ResultsOverall, 50.3% of students were aware of e-cigarettes; prevalence of ever and current use of e-cigarettes was 6.8% and 2.1%, respectively. Awareness of hookah was 41.2% among all students, and that of ever and current use were 8.9% and 3.6%, respectively. Overall awareness; ever; and current use of snus (32%, 5.3%, 1.7%, respectively) and dissolvables (19.3%, 2.0%, 0.7%, respectively) were generally lower than those of e-cigarettes or hookah. Conventional tobacco product users were more likely to be aware of and to use non-conventional tobacco products.ConclusionsMany U.S. students are aware of and use non-conventional tobacco products. Evidence-based interventions should be implemented to prevent and reduce all tobacco use among youth

When Families, Organizational Culture, and Policy Collide: A Mixed Method Study of Alternative Response

Objective Alternative response (AR) is a family-centered, preventative approach for child protection systems. This study first examined what family and case factors predicted re-investigation and then explored which organizational factors influence caseworker and agency implementation of AR. Method Using administrative data from child protection reports, AR families (N = 9,959) and traditional response (TR) families (N = 13,974) were followed for 18 months to determine re-investigation rates using multilevel modeling where families were nested in county of residence. Four focus groups with 14 participants were conducted to discuss the quantitative findings, organizational culture, and implementation of AR. Results AR families had lower odds of re-investigation; males and younger children also had lower odds. Families with multiple children, prior investigations, receipt of Medicaid, and medium/high risk had higher odds of re-investigation. AR caseworkers provided insights regarding the intersection of family factors, organizational culture and support, and agency implementation of AR. Although participants supported AR, their ability to implement it was influenced by agency support and availability of resources to carry out the basic requirements of the policy. A clear distinction in responses emerged between those who held dual cases versus those holding only AR cases. Conclusion Although AR reduces the odds of re-investigation for low-risk families and was endorsed by caseworkers, AR policy in practice is complex and requires further evaluation, particularly from the perspective of AR caseworkers who faced implementation hurdles

Severity of food insecurity among Australian University students, professional and academic staff

Assessments of the severity of food insecurity within Australian university students are lacking, and the experience of food insecurity in Australian university staff is unknown. A cross-sectional online survey in March 2022 aimed to characterize the severity of food insecurity in students, professional and academic staff at the University of Tasmania (UTAS). The Household Food Security Survey Module six-item short form assessed food security status in addition to seven demographic and education characteristics for students and six demographic and employment characteristics for staff. Participants were categorized as having high, marginal, low, or very low food security. Multivariate binary logistic regression identified students and staff at higher risk of food insecurity. Among student respondents (n = 1257), the prevalence of food insecurity was 41.9% comprising 8.2% marginal, 16.5% low, and 17.3% very low food security. Younger, non-binary, first-year enrolled, on campus, and international students were at significantly higher risk of food insecurity. Among staff (n = 560), 16.3% were food insecure comprising 3.8% marginal, 5.5% low, and 7.0% very low food security. Professional staff, staff on casual contracts, and staff recently employed, were at significantly higher risk of food insecurity. Our findings suggest a high occurrence of food insecurity in UTAS students and staff, with a large proportion of food insecure staff and students experiencing very low food security. Our findings have implications for efforts towards reducing food insecurity at university campuses through a holistic and integrated approach, advocating for food systems that support healthy, sustainable, and equitable food procurement and provision for both university students and staff

Urocortin 2 inhibits human aortic smooth muscle cell proliferation via corticotrophin releasing hormone receptor-2 in abdominal aortic aneurysm

Introduction: A key feature of abdominal aortic aneurysm is the loss of proliferation and paucity of vascular smooth muscle cells, the major cells within the aortic tunica media. It has been suggested that urocortin 2 (UCN2), a selective ligand for corticotrophin releasing factor receptor 2 (CRFR2) may play a beneficial role in various cardiovascular diseases. However, the role of this peptide in abdominal aortic aneurysm has not been studied in detail. Here we assessed the hypothesis that urocortin 2 promotes an aneurysm phenotype in human aortic smooth muscles in vitro via CRFR2. Experimental Procedure: We assessed the release of UCN2 from explants of human tissue biopsies in vitro (Aortic aneurysm thrombus, n = 14; aortic aneurysm body, n = 11; femoral atheroma control, n = 6) using ELISA. We investigated the effect of incubating human aortic smooth muscle cells with recombinant UCN2 or aneurysm thrombus explants secretions at a UCN2 dose of 0, 10 and 100 nM for 24 and 48 hours (n = 6 per group x 3 experiments). Cell proliferation was determined by the alamarBlue® cell viability reagent. Results were analyzed and presented as mean ± SEM relative to the control. We also investigated the impact of blocking CRFR2 on UCN2 induced changes on these cells. Results: Secretion of UCN2 was significantly higher from aneurysm thrombus (n = 14, p = 0.0020) and aneurysm body (n = 11, p = 0.0104) compared to femoral atheroma. Human aortic smooth muscle cells proliferation was dose dependently inhibited by recombinant UCN2 (p = 0.0172) and aortic aneurysm thrombus conditioned medium (p = 0.0273) after 24 hours. This effect of recombinant UCN2 was abrogated significantly by prior incubation with the CRFR2 blocker Astressin-2B (p = 0.0043). Similar effects were seen on incubating cells for 48 hours. Conclusion: UCN2 is released in high concentrations by aortic aneurysm thrombus. UCN2 inhibits aortic vascular smooth muscle cell proliferation in vitro via CRFR2. This effect may be relevant to the pathogenesis of abdominal aortic aneurysm

Urocortin 2 inhibits human aortic smooth muscle cell proliferation via corticotrophin releasing hormone receptor-2 in abdominal aortic aneurysm

Introduction: A key feature of abdominal aortic aneurysm is the loss of proliferation and paucity of vascular smooth muscle cells, the major cells within the aortic tunica media. It has been suggested that urocortin 2 (UCN2), a selective ligand for corticotrophin releasing factor receptor 2 (CRFR2) may play a beneficial role in various cardiovascular diseases. However, the role of this peptide in abdominal aortic aneurysm has not been studied in detail. Here we assessed the hypothesis that urocortin 2 promotes an aneurysm phenotype in human aortic smooth muscles in vitro via CRFR2. Experimental Procedure: We assessed the release of UCN2 from explants of human tissue biopsies in vitro (Aortic aneurysm thrombus, n = 14; aortic aneurysm body, n = 11; femoral atheroma control, n = 6) using ELISA. We investigated the effect of incubating human aortic smooth muscle cells with recombinant UCN2 or aneurysm thrombus explants secretions at a UCN2 dose of 0, 10 and 100 nM for 24 and 48 hours (n = 6 per group x 3 experiments). Cell proliferation was determined by the alamarBlue® cell viability reagent. Results were analyzed and presented as mean ± SEM relative to the control. We also investigated the impact of blocking CRFR2 on UCN2 induced changes on these cells. Results: Secretion of UCN2 was significantly higher from aneurysm thrombus (n = 14, p = 0.0020) and aneurysm body (n = 11, p = 0.0104) compared to femoral atheroma. Human aortic smooth muscle cells proliferation was dose dependently inhibited by recombinant UCN2 (p = 0.0172) and aortic aneurysm thrombus conditioned medium (p = 0.0273) after 24 hours. This effect of recombinant UCN2 was abrogated significantly by prior incubation with the CRFR2 blocker Astressin-2B (p = 0.0043). Similar effects were seen on incubating cells for 48 hours. Conclusion: UCN2 is released in high concentrations by aortic aneurysm thrombus. UCN2 inhibits aortic vascular smooth muscle cell proliferation in vitro via CRFR2. This effect may be relevant to the pathogenesis of abdominal aortic aneurysm

Angiopoietin-2 attenuates angiotensin II-induced aortic aneurysm and atherosclerosis in apolipoprotein E-deficient mice

Angiogenesis and inflammation are implicated in aortic aneurysm and atherosclerosis and regulated by angiopoietin-2 (Angpt2). The effect of Angpt2 administration on experimental aortic aneurysm and atherosclerosis was examined. Six-month-old male apolipoprotein E deficient (ApoE⁻/⁻) mice were infused with angiotensin II (AngII) and administered subcutaneous human Fc-protein (control) or recombinant Angpt2 (rAngpt2) over 14 days. Administration of rAngpt2 significantly inhibited AngII-induced aortic dilatation and rupture of the suprarenal aorta (SRA), and development of atherosclerosis within the aortic arch. These effects were blood pressure and plasma lipoprotein independent and associated with Tie2 activation and down-regulation of monocyte chemotactic protein-1 (MCP-1) within the SRA. Plasma concentrations of MCP-1 and interleukin-6 were significantly lower in mice receiving rAngpt2. Immunostaining for the monocyte/macrophage marker MOMA-2 and the angiogenesis marker CD31 within the SRA were less in mice receiving rAngpt2 than controls. The percentage of inflammatory (Ly6Cʰⁱ) monocytes within the bone marrow was increased while that in peripheral blood was decreased by rAngpt2 administration. In conclusion, administration of rAngpt2 attenuated angiotensin II-induced aortic aneurysm and atherosclerosis in ApoE⁻/⁻ mice associated with reduced aortic inflammation and angiogenesis. Up-regulation of Angpt2 may have potential therapeutic value in patients with aortic aneurysm and atherosclerosis