Psychosocial and Re-Incarceration Risks Among Older Adults in Mental Health Courts

Objective Older adults are increasingly involved in the criminal justice system, yet there is limited research regarding their needs and experiences. This study examined differences in psychosocial experiences and reincarceration between older and younger adults with psychiatric disorders involved in the criminal justice system. Methods Participants (N = 80) were recruited from two mental health courts in the midwestern United States. Bivariate analyses examined age-related differences in psychosocial experiences and reincarceration between younger and older participants. Results Older adults, on average, experienced more treatment adherence and fewer probation violations than younger adults during the 6-month follow-up; however, they experienced comparable risk for reincarceration. Older adults\u27 substance use, service use, housing instability, and program retention were similar to their younger counterparts. Conclusion Despite older mental health court participants\u27 treatment adherence and reduced probation violations, they are at risk for incarceration, substance use, and housing instability

Health Vulnerability Model for Latinx Sexual and Gender Minorities: Typologies with Socioeconomic Stability, Health Care Access, and Social Characteristics Indicators

Vulnerability can undermine positive health outcomes and challenge healthcare services access. However, to date, vulnerable populations research has been limited by overly broad definitions, lack of clear indicators, and failure to explore subtypes of vulnerability. Informed by literature and theory, this analysis used a specific operationalization of health vulnerability to identify typologies among a sample of Latinx sexual and gender minorities. We analyzed baseline data from Latinx sexual and gender minorities (N = 186) recruited for a community-based HIV intervention. We performed latent class analysis to operationalize vulnerability using eight socioeconomic stability, health care access, and social characteristics indicators. We identified three typologies of vulnerability from our sample: Low Education and High Social Support (63.4% of sample), High Education and Year-round Employment (18.8%), and High Education and High Discrimination (17.7%). Using specific indicators produced more nuanced vulnerability typologies which, after further testing, can assist in informing tailored health promotion interventions

Spirocyclic chromanes exhibit antiplasmodial activities and inhibit all intraerythrocytic life cycle stages

AbstractWe screened a collection of synthetic compounds consisting of natural-product-like substructural motifs to identify a spirocyclic chromane as a novel antiplasmodial pharmacophore using an unbiased cell-based assay. The most active spirocyclic compound UCF 201 exhibits a 50% effective concentration (EC50) of 350 nM against the chloroquine-resistant Dd2 strain and a selectivity over 50 using human liver HepG2 cells. Our analyses of physicochemical properties of UCF 201 showed that it is in compliance with Lipinski's parameters and has an acceptable physicochemical profile. We have performed a limited structure-activity-relationship study with commercially available chromanes preserving the spirocyclic motif. Our evaluation of stage specificities of UCF 201 indicated that the compound is early-acting in blocking parasite development at ring, trophozoite and schizont stages of development as well as merozoite invasion. SPC is an attractive lead candidate scaffold because of its ability to act on all stages of parasite's aexual life cycle unlike current antimalarials

AMP-activated protein kinase-α1 as an activating kinase of TGF-β-activated kinase 1 has a key role in inflammatory signals

Although previous studies have proposed plausible mechanisms of the activation of transforming growth factor-β-activated kinase 1 (TAK1) in inflammatory signals, including Toll-like receptors (TLRs), its activating kinase still remains to be unclear. In the present study, we have provided evidences that AMP-activated protein kinase (AMPK)-α1 has a pivotal role for activating TAK1, and thereby regulate NF-κB-dependent gene expressions in inflammatory signaling mediated by TLR4 and TNF-α stimulation. AMPK-α1 specifically interacts with TAK1 and reciprocally regulates their kinase activities. Upon the stimulation of lipopolysaccharide, AMPK-α1-knockdown (AMPK-$\alpha 1^{KD}$) or TAK1-knockdown human monocytic THP-1 cells exhibit a dramatic reduction in the TAK1 or AMPK-α1 kinase activity, respectively, and subsequent suppressions of its downstream signaling cascades, which further leads to inhibitions of NF-κB and thereby productions of proinflammatory cytokines, such as TNF-α, IL-1β, and IL-6. Importantly, the microarray analysis of AMPK-$\alpha 1^{KD}$ cells revealed a dramatic reduction in the NF-κB-dependent genes induced by TLR4 and TNF-α stimulation, and the observation was in significant correlation with the results of quantitative real-time PCR. Moreover, AMPK-$\alpha 1^{KD}$ cells are highly sensitive to the TNF-α-induced apoptosis, which is accompanied with dramatic reductions in the NF-κB-dependent and anti-apoptotic genes. As a result, our data demonstrate that AMPK-α1 as an activating kinase of TAK1 has a key role in mediating inflammatory signals triggered by TLR4 and TNF-α

Promoting Community and Population Health in Public Health and Medicine: A Stepwise Guide to Initiating and Conducting Community-engaged Research

Various methods, approaches, and strategies designed to understand and reduce health disparities, increase health equity, and promote community and population health have emerged within public health and medicine. One such approach is community-engaged research. While the literature describing the theory, principles, and rationale underlying community engagement is broad, few models or frameworks exist to guide its implementation. We abstracted, analyzed, and interpreted data from existing project documentation including proposal documents, project-specific logic models, research team and partnership meeting notes, and other materials from 24 funded community-engaged research projects conducted over the past 17 years. We developed a 15-step process designed to guide the community-engaged research process. The process includes steps such as: networking and partnership establishment and expansion; building and maintaining trust; identifying health priorities; conducting background research, prioritizing “what to take on”; building consensus, identifying research goals, and developing research questions; developing a conceptual model; formulating a study design; developing an analysis plan; implementing the study; collecting and analyzing data; reviewing and interpreting results; and disseminating and translating findings broadly through multiple channels. Here, we outline and describe each of these steps

Cuidado de enfermagem para enfermeiros docentes na perspectiva da complexidade

O cuidado de enfermagem complexo é condição essencial para a compreensão do ser humano como singular e multidimensional. Assim, objetivou-se conhecer o significado do cuidado de enfermagem para enfermeiros docentes, na perspectiva da complexidade. Trata-se de uma pesquisa qualitativa, realizada com sete enfermeiros docentes deum curso de enfermagem de nível superior da região central do Rio Grande do Sul, Brasil. Os dados foram coletados no mês de novembro de 2011, por meio do grupo focal, a partir de três encontros, sistematizados com temáticas que contemplassem o objetivo deste estudo. Para a análise de dados, foi utilizada a análise textual discursiva. Os resultados evidenciaram o cuidado de enfermagem como construção singular que vai além de um cuidado técnico-prescritivo, pontual e linear. Conclui-se que o cuidado de enfermagem não pode ser concebido como açãoreducionista, mas como construção singular, que envolve interações, reflexões e autoconhecimento

Barriers to HIV Testing Within a Sample of Spanish-speaking Latinx Gay, Bisexual, and Other Men Who Have Sex with Men: Implications for HIV Prevention and Care

Gay, bisexual, and other men who have sex with men (GBMSM) have higher rates of HIV infection compared to the general population in the United States, and the infection rate is growing among Latinx GBMSM, compared to a decline in most other demographic subgroups. Uptake of pre-exposure prophylaxis (PrEP), a biomedical strategy designed to reduce HIV transmission, is very low among Latinx GBMSM. HIV testing is a critical first step in the HIV prevention and care continua. We analyzed data from a community-based sample of Latinx GBMSM in the southeastern United States to identify the most common HIV testing barriers and the factors associated with barriers. The five most commonly reported HIV testing barriers included not knowing where to get tested, not having health insurance, fear of being HIV positive, practicing safer sex and perceiving not needing to be tested, and not being recommended to get tested. Using multivariable logistic regression modeling, speaking only Spanish, being unemployed, and adhering to traditional notions of masculinity were associated with increased barriers to HIV testing. We recommend that interventions to increase HIV testing among Latinx GBMSM be provided in Spanish and use culturally congruent messaging, be accessible to those who are unemployed, and incorporate positive risk-reducing aspects of masculinity

Genetic variants in TKT and DERA in the NADPH pathway predict melanoma survival

Background: Cutaneous melanoma (CM) is the most lethal type of skin cancers. Nicotinamide adenine dinucleotide phosphate (NADPH) plays an important role in anabolic reactions and tumorigenesis, but many genes are involved in the NADPH system. Methods: We used 10,912 single-nucleotide polymorphisms (SNPs) (2018 genotyped and 8894 imputed) in 134 NADPH-related genes from a genome-wide association study (GWAS) of 858 patients from The University of Texas MD Anderson Cancer Center (MDACC) in a single-locus analysis to predict CM survival. We then replicated the results in another GWAS data set of 409 patients from the Nurses' Health Study (NHS) and the Health Professionals Follow-up Study (HPFS). Results: There were 95 of 858 (11.1%) and 48 of 409 (11.7%) patients who died of CM, respectively. In multivariable Cox regression analyses, we identified two independent SNPs (TKT rs9864057 G > A and deoxyribose phosphate aldolase (DERA) rs12297652 A > G) to be significantly associated with CM-specific survival [hazards ratio (HR) of 1.52, 95% confidence interval (CI) = 1.18-1.96, P = 1.06 × 10-3 and 1.51 (1.19-1.91, 5.89 × 10-4)] in the meta-analysis, respectively. Furthermore, an increasing number of risk genotypes of these two SNPs was associated with a higher risk of death in the MDACC, the NHS/HPFS, and their combined data sets (Ptrend A and DERA rs12297652 A > G were also significantly associated with higher mRNA expression levels in sun-exposed lower-leg skin (P = 0.043 and 0.006, respectively). Conclusions: These results suggest that these two potentially functional SNPs may be valuable prognostic biomarkers for CM survival, but larger studies are needed to validate these findings

Transglutaminase 2 facilitates the distant hematogenous metastasis of breast cancer by modulating interleukin-6 in cancer cells

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.Abstract Introduction Inflammation has been implicated in cancer aggressiveness. As transglutaminase 2 (TG2), which has been associated with inflammatory signaling, has been suggested to play a role in tumor behavior, we propose that TG2 may be an important linker inducing interleukin (IL)-6-mediated cancer-cell aggressiveness, including distant hematogenous metastasis. Methods To investigate the role for TG2 and IL-6, TG2-knocked-down and IL-6-knocked-down cancer cells were generated by using shRNA. Human breast cancer cell xenograft model in highly immunocompromised mice and human advanced breast cancer primary tumor tissue microarrays were used in this study. Results IL-6 production in human breast cancer cells was dependent on their TG2 expression level. In vitro tumor-sphere formation was dependent on TG2 and downstream IL-6 production from cancer cells. Primary tumor growth in the mammary fat pads and distant hematogenous metastasis into the lung was also dependent on TG2 and downstream IL-6 expression levels. The effect of TG2 expression on human breast cancer distant metastasis was investigated by analyzing a tissue microarray of primary tumors from 412 patients with their clinical data after 7 years. TG2 expression in primary tumor tissue was inversely correlated with recurrence-free survival (P = 0.019) and distant metastasis-free survival (DMFS) (P = 0.006) in patients with advanced breast cancer. Furthermore, by using public datasets that included a total of 684 breast cancer patients, we found that the combined high expression of TG2 and IL-6 was associated with shorter DMFS, compared with the high expression of IL-6 only (P = 0.013). Conclusions We provide evidence that TG2 is an important link in IL-6-mediated tumor aggressiveness, and that TG2 could be an important mediator of distant metastasis, both in a xenograft animal model and in patients with advanced breast cancer

Democratic Leadership - A local story

Leadership is traditionally viewed as an individual property and researched from the perspective of behaviours, traits or characteristics that these individuals possess. Notions of democratic leadership can offer early childhood centres a more expansive conception of leadership to include children, teachers and families. This study explores the possibility of positioning all stakeholders in an early childhood centre as leaders by repositioning leadership as a jointly constructed, emergent process. Drawing on an existing feature of the kindergarten programme, that of regular excursions within the local community, connections are interwoven between children’s inquires, democratic principles and elements of place based education. Using narratives from five excursions in the local community the study experiments with Leadership-as-practice to analyse how these excursions fostered democratic and inclusive participation of children and adults. Inquiry as a form of participatory democracy is a key feature of decision-making and provides a common purpose for community excursions while encouraging leadership opportunities. The study reveals the potential of leadership-as-practice, underpinned by democratic values as an approach to leadership in early childhood organisations, enabling leader/follower roles to be blurred and learning to be co constructed during dialogue. The local community holds enormous capacity as a system to facilitate democratic leadership and promote place based learning and citizenship education. This study recognises that democratic leadership exists in tension with current neo liberal beliefs and therefore positions itself as a counter to the current market driven early childhood environment. The underlying belief of this study is that leadership can occur as a collaborative practice, emerging through day to day experiences and seeks to contribute to the slowly emerging body of research concerned with early childhood leadership.