Barriers and facilitators to salivary rapid HIV testing in African Americans

OBJECTIVE: To identify barriers and facilitators of voluntary Salivary Rapid HIV testing decisions (SRT) among African Americans in order to develop interventions to improve HIV testing rates and care entry if HIV positive. METHODS: This first phase of a two-phase study used a Comprehensive Health Seeking and Coping Paradigm-based semi-structured interview guide (SSIG) to conduct 10 focus groups of 2-5 African Americans recruited from a large STI Clinic. Content analysis of the focus group transcripts was done using line-by-line analysis, and reviewing sentences and phrases for patterns or core meanings. Patterns were refined and synthesized into descriptive statements. An iterative process of comparison was used to further analyze the data, moving between individual elements of the text specific to participant responses. Meanings that were implicit rather than explicit in the text; and of one whole account with another were used to identify overall patterns of meaning. RESULTS: Of the 38 African American adults recruited, 16 were female with ages 18-49 (M =23) and 22 were male with ages 18-49 (M=29.5). All self identified as heterosexual with most reporting low income and no health insurance. Within the context of barriers and facilitators to SRT, eight themes emerged: Familiarity, Stigma, Fear, Access, Immediacy, Ease, Degree of Responsibility, and Trust. Each theme was not seen exclusively as a barrier or facilitator but was interpreted to be one or the other depending on the aspect of HIV testing being discussed. A gender sub analysis revealed themes of health maintenance and illness management for females and males respectively. CONCLUSIONS: Since there has not been an increase in HIV testing rates in AA’s even with newer SRT technology. The findings support the need to assess barriers and facilitators to testing decisions in order to increase testing rates. The themes also suggest the need for tailored community based interventions that decrease fear, stigma and increase trust in testing methods and providers for HIV and STI screening

Roles of GM-CSF in the Pathogenesis of Autoimmune Diseases: An Update.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) was first described as a growth factor that induces the differentiation and proliferation of myeloid progenitors in the bone marrow. GM-CSF also has an important cytokine effect in chronic inflammatory diseases by stimulating the activation and migration of myeloid cells to inflammation sites, promoting survival of target cells and stimulating the renewal of effector granulocytes and macrophages. Because of these pro-cellular effects, an imbalance in GM-CSF production/signaling may lead to harmful inflammatory conditions. In this context, GM-CSF has a pathogenic role in autoimmune diseases that are dependent on cellular immune responses such as multiple sclerosis (MS) and rheumatoid arthritis (RA). Conversely, a protective role has also been described in other autoimmune diseases where humoral responses are detrimental such as myasthenia gravis (MG), Hashimoto\u27s thyroiditis (HT), inflammatory bowel disease (IBD), and systemic lupus erythematosus (SLE). In this review, we aimed for a comprehensive analysis of literature data on the multiple roles of GM-CSF in autoimmue diseases and possible therapeutic strategies that target GM-CSF production

IL-1β Promotes TGF-β1 and IL-2 Dependent Foxp3 Expression in Regulatory T Cells

Earlier, we have shown that GM-CSF-exposed CD8α− DCs that express low levels of pro-inflammatory cytokines IL-12 and IL-1β can induce Foxp3+ Tregs leading to suppression of autoimmunity. Here, we examined the differential effects of IL-12 and IL-1β on Foxp3 expression in T cells when activated in the presence and absence of DCs. Exogenous IL-12 abolished, but IL-1β enhanced, the ability of GM-CSF-exposed tolerogenic DCs to promote Foxp3 expression. Pre-exposure of DCs to IL-1β and IL-12 had only a modest effect on Foxp3− expressing T cells; however, T cells activated in the absence of DCs but in the presence of IL-1β or IL-12 showed highly significant increase and decrease in Foxp3+ T cell frequencies respectively suggesting direct effects of these cytokines on T cells and a role for IL-1β in promoting Foxp3 expression. Importantly, purified CD4+CD25+ cells showed a significantly higher ability to maintain Foxp3 expression when activated in the presence of IL-1β. Further analyses showed that the ability of IL-1β to maintain Foxp3 expression in CD25+ T cells was dependent on TGF-β1 and IL-2 expression in Foxp3+Tregs and CD25− effectors T cells respectively. Exposure of CD4+CD25+ T cells to IL-1β enhanced their ability to suppress effector T cell response in vitro and ongoing experimental autoimmune thyroidits in vivo. These results show that IL-1β can help enhance/maintain Tregs, which may play an important role in maintaining peripheral tolerance during inflammation to prevent and/or suppress autoimmunity

Retention and Academic Success of First-Generation College Students in a Pre-Orientation Program at a Selective, Private, Mid-Sized University

This study analyzed the retention and academic success of first-generation college student pre-orientation participants drawn from a first-generation college student population at a selective, private, mid-sized university located in the Mid-Atlantic region of the United States. Students selected for the pre-orientation program were identified as students more likely to struggle with the college transition. Literature regarding the success of pre-orientation programs and the experience of first-generation college students at private, four-year institutions is limited. Research questions examined the retention rates and academic success, defined as cumulative grade point average and awarded credit hours, of first-generation college student pre-orientation participants versus the first-generation college student population at the university. Findings indicate that the pre-orientation participants were retained at a higher rate than the first-generation college student population. No statistical difference was found regarding cumulative grade point average and credit hours awarded between the pre-orientation participants and first-generation college student population. Results suggest that the pre-orientation participants’ academic performance is on par with the first-generation college student population at the university. Recommendations for practice and further research include enhancing the academic component of the program through the development of a summer bridge program, expanding assessment efforts to assess student learning outcomes and student engagement, and conducting a longitudinal study to compare graduation rates

Retention and Academic Success of First-Generation College Students in a Pre-Orientation Program at a Selective, Private, Mid-Sized University

This study analyzed the retention and academic success of first-generation college student pre-orientation participants drawn from a first-generation college student population at a selective, private, mid-sized university located in the Mid-Atlantic region of the United States. Students selected for the pre-orientation program were identified as students more likely to struggle with the college transition. Literature regarding the success of pre-orientation programs and the experience of first-generation college students at private, four-year institutions is limited. Research questions examined the retention rates and academic success, defined as cumulative grade point average and awarded credit hours, of first-generation college student pre-orientation participants versus the first-generation college student population at the university. Findings indicate that the pre-orientation participants were retained at a higher rate than the first-generation college student population. No statistical difference was found regarding cumulative grade point average and credit hours awarded between the pre-orientation participants and first-generation college student population. Results suggest that the pre-orientation participants’ academic performance is on par with the first-generation college student population at the university. Recommendations for practice and further research include enhancing the academic component of the program through the development of a summer bridge program, expanding assessment efforts to assess student learning outcomes and student engagement, and conducting a longitudinal study to compare graduation rates

Immunomodulation of dendritic cells in autoimmune type 1 diabetes mellitus.

Immunomodulation of dendritic cells in autoimmune type 1 diabetes mellitus

GM-CSF expanded tolerogenic CD11c+CD8a− dendritic cells can induce autoantigen specific CD4+ CD25+ Foxp3+ T regulatory cells (128.11)

Abstract Treatment of CBA/j mice with Granulocyte Macrophage Colony Stimulating Factor (GM-CSF), a potent growth factor for dendritic cells can prevent and suppress ongoing experimental autoimmune thyroiditis (EAT). GM-CSF treatment causes expansion of CD11c+CD8a− myeloid dendritic cells (DCs) with a consequent increase in CD4+CD25+ T regulatory cells (Tregs) in an EAT model. In this study, we investigated the significance of the expansion of CD8a− myeloid DCs by GM-CSF and its direct role in inducing CD4+CD25+Foxp3+ T regs. Co-culture of CD4+ T cells with CD8a-ve DCs from GM-CSF treated mice in the presence of mouse thyroglobulin (mTg) induced an increase in the number of CD4+CD25+Foxp3+ T cells. These Foxp3+ T cells produced high levels of IL-10. These T regs could suppress the mTg specific proliferation of effector CD4+CD25− T cells, which was reversed upon addition of anti-IL10R antibodies. In contrast, GM-CSF treated CD8a+ lymphoid DCs failed to show a significant suppression of mTg specific T cell proliferation. In vivo experiments in a SCID mouse model revealed that GM-CSF treated SCID mice could induce increased numbers of Foxp3 and IL-10 expressing CD4+ T cells that were adoptively transferred from wild type CBA/j mice. These results indicate that GM-CSF acts directly on CD8a− myeloid DCs in the absence of T cells and renders them tolerogenic in that they cause expansion of CD4+Foxp3+ Tregs, which suppress mTg specific proliferation in an IL-10 dependent manner. NIH 1RO1AI058190</jats:p

Barriers and facilitators to salivary rapid HIV testing in African Americans

OBJECTIVE: To identify barriers and facilitators of voluntary Salivary Rapid HIV testing decisions (SRT) among African Americans in order to develop interventions to improve HIV testing rates and care entry if HIV positive. METHODS: This first phase of a two-phase study used a Comprehensive Health Seeking and Coping Paradigm-based semi-structured interview guide (SSIG) to conduct 10 focus groups of 2-5 African Americans recruited from a large STI Clinic. Content analysis of the focus group transcripts was done using line-by-line analysis, and reviewing sentences and phrases for patterns or core meanings. Patterns were refined and synthesized into descriptive statements. An iterative process of comparison was used to further analyze the data, moving between individual elements of the text specific to participant responses. Meanings that were implicit rather than explicit in the text; and of one whole account with another were used to identify overall patterns of meaning. RESULTS: Of the 38 African American adults recruited, 16 were female with ages 18-49 (M =23) and 22 were male with ages 18-49 (M=29.5). All self identified as heterosexual with most reporting low income and no health insurance. Within the context of barriers and facilitators to SRT, eight themes emerged: Familiarity, Stigma, Fear, Access, Immediacy, Ease, Degree of Responsibility, and Trust. Each theme was not seen exclusively as a barrier or facilitator but was interpreted to be one or the other depending on the aspect of HIV testing being discussed. A gender sub analysis revealed themes of health maintenance and illness management for females and males respectively. CONCLUSIONS: Since there has not been an increase in HIV testing rates in AA’s even with newer SRT technology. The findings support the need to assess barriers and facilitators to testing decisions in order to increase testing rates. The themes also suggest the need for tailored community based interventions that decrease fear, stigma and increase trust in testing methods and providers for HIV and STI screening