Dietary Sodium and Blood Pressure in Older Adults

Given the proportion of older adults who are hypertensive and the population of older adults who are at risk for hypertension, the U.S. must mobilize public health efforts aimed at prevention. Scientific evidence has demonstrated the efficacy of sodium reduction to lower blood pressure. Translating this evidence into practice involves knowledge about the food sources of sodium so effective interventions can be designed and implemented. The purpose of this essay was to examine major food group sources of sodium in a cohort of older adults, with and without high blood pressure, in an urban community in Southwestern Pennsylvania. The University of Pittsburgh's "Center for Healthy Aging" promotes healthy aging in the community with the "10 Keys to Healthy Aging" campaign. One of the keys aims to lower systolic blood pressure to ≤140 mmHg. A low sodium intervention was implemented by the CHA project in hypertensive individuals. The sodium intake of the 521 community volunteers, mean age 74.5 years, 60% male, 94.1% white, who completed a FFQ, was compared to a sub-sample of hypertensives (n=214) who, in addition, collected one 24-hour urinary sodium. Mean baseline dietary sodium for the entire cohort was 1,796 mg per day compared to 1,821 mg per day in hypertensives. Urinary sodium was 1.8 times higher (141 mmol/24 hrs [3,240 mg]) than self-reported intake and decreased to 130 mmol/24 hrs (2,990 mg) at 6-months. The correlation between dietary and urinary sodium at baseline was weak (r=0.16) and remained weak (0.23) at 6-months. Major food sources of sodium were soups, breads, tomato sauce, salad dressings, and prepared cereals. Data indicate that the sodium intake of the group exceeds the 2005 Dietary Guidelines of ≤1500 mg per day by approximately 200% for individuals at increased risk using urinary sodium values. Even the most successful dietary interventions to reduce sodium intake to the recommended levels would be ineffective without the food industry’s help in reducing sodium added to foods during processing. This prevention strategy, in combination with stronger public health messages, would help to reduce the sodium intake in the population and help to achieve reductions in blood pressures

Far from Home: A Qualitative Analysis of Altered Social and Familial Interactions by Students Attending College Significant Distances from Home

This study explored the necessary modifications for students’ relationships with their home contexts (social and familial) as they acclimated to college life. We specifically targeted students living over 1,000 miles from their present school setting. Thirty undergraduate students at a private Midwest university participated in this qualitative phenomenological research study through semistructured interviews. While numerous dynamics surfaced, repeated themes included feelings of homesickness, desiring to go home, weakening of peer relationships established at home, and gradual strengthening of familial relationships

Sources by Which Students Perceive Professional Counselors\u27 Effectiveness

Using qualitative research methods interviews were conducted with college students regarding the sources they used in generating perceptions of professional counselors. Respondents believed that word of mouth, media sources, and personal experiences were responsible for their understandings of professional counselors. The findings have applications for leaders in professional counseling organizations

Attitudinal Outcomes of a Multicultural Learning Community Experience: A Qualitative Analysis

Research investigating the long-term effects of learning communities on students is scarce. This qualitative study focuses on the results of 24 in-depth interviews with students three years after participating in a first year learning community at a private, selective Midwestern university. Interview questions were designed to probe students’ shifts in personal biases and stereotypes, factors related to their decisions to become involved with the learning community, self-reported levels of satisfaction with the learning community, and suggestions for improving future learning communities. Results of the interviews were positive, and also suggested the value of explicit communication about the purpose of the learning community. The authors point out the value of ongoing continuous improvement efforts

Lrp4 Regulates Initiation of Ureteric Budding and Is Crucial for Kidney Formation – A Mouse Model for Cenani-Lenz Syndrome

Background: Development of the kidney is initiated when the ureteric bud (UB) branches from the Wolffian duct and invades the overlying metanephric mesenchyme (MM) triggering the mesenchymal/epithelial interactions that are the basis of organ formation. Multiple signaling pathways must be integrated to ensure proper timing and location of the ureteric bud formation. Methods and Principal Findings: We have used gene targeting to create an Lrp4 null mouse line. The mutation results in early embryonic lethality with a subpenetrant phenotype of kidney agenesis. Ureteric budding is delayed with a failure to stimulate the metanephric mesenchyme in a timely manner, resulting in failure of cellular differentiation and resulting absence of kidney formation in the mouse as well as comparable malformations in humans with Cenani-Lenz syndrome. Conclusion: Lrp4 is a multi-functional receptor implicated in the regulation of several molecular pathways, including Wnt and Bmp signaling. Lrp4 2/2 mice show a delay in ureteric bud formation that results in unilateral or bilateral kidney agenesis. These data indicate that Lrp4 is a critical regulator of UB branching and lack of Lrp4 results in congenital kidne

PI3K/mTOR Dual Inhibitor PF-04691502 Is a Schedule-Dependent Radiosensitizer for Gastroenteropancreatic Neuroendocrine Tumors

Patients with advanced-stage gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have a poor overall prognosis despite chemotherapy and radiotherapy (e.g., peptide receptor radionuclide therapy (PRRT)). Better treatment options are needed to improve disease regression and patient survival. The purpose of this study was to examine a new treatment strategy by combining PI3K/mTOR dual inhibition and radiotherapy. First, we assessed the efficacy of two PI3K/mTOR dual inhibitors, PF-04691502 and PKI-402, to inhibit pAkt and increase apoptosis in NET cell lines (BON and QGP-1) and patient-derived tumor spheroids as single agents or combined with radiotherapy (XRT). Treatment with PF-04691502 decreased pAkt (Ser473) expression for up to 72 h compared with the control; in contrast, decreased pAkt expression was noted for less than 24 h with PKI-402. Simultaneous treatment with PF-04691502 and XRT did not induce apoptosis in NET cells; however, the addition of PF-04691502 48 h after XRT significantly increased apoptosis compared to PF-04691502 or XRT treatment alone. Our results demonstrate that schedule-dependent administration of a PI3K/mTOR inhibitor, combined with XRT, can enhance cytotoxicity by promoting the radiosensitivity of NET cells. Moreover, our findings suggest that radiotherapy, in combination with timed PI3K/mTOR inhibition, may be a promising therapeutic regimen for patients with GEP-NET

Proceedings of the Working Group Session on Fertility Preservation for Individuals with Gender and Sex Diversity

Children and adolescents with gender and sex diversity include (1) gender-nonconforming and transgender individuals for whom gender identity or expression are incongruent with birth-assigned sex (heretofore, transgender) and (2) individuals who have differences in sex development (DSD). Although these are largely disparate groups, there is overlap in the medical expertise necessary to care for individuals with both gender and sex diversity. In addition, both groups face potential infertility or sterility as a result of desired medical and surgical therapies. The Ann and Robert H. Lurie Children's Hospital of Chicago (Lurie Children's) gender and sex development program (GSDP) provides specialized multidisciplinary care for both transgender and DSD patients. In response to patient concerns that recommended medical treatments have the potential to affect fertility, the Lurie Children's GSDP team partnered with experts from the Oncofertility Consortium at Northwestern University to expand fertility preservation options to gender and sex diverse youth. This article summarizes the results of a meeting of experts across this field at the annual Oncofertility Consortium conference with thoughts on next steps toward a unified protocol for this patient group.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140296/1/trgh.2016.0008.pd

An exploration of concomitant psychiatric disorders in children with autism spectrum disorder

Objective We explored patterns of concomitant psychiatric disorders in a large sample of treatment-seeking children and adolescents with autism spectrum disorder (ASD). Methods Participants were 658 children with ASD (age 3–17 years; mean = 7.2 years) in one of six federally-funded multisite randomized clinical trials (RCT) between 1999 and 2014. All children were referred for hyperactivity or irritability. Study designs varied, but all used the Child and Adolescent Symptom Inventory or Early Childhood Inventory to assess Attention Deficit Hyperactivity Disorder (ADHD), Oppositional-Defiant Disorder (ODD), Conduct Disorder (CD), Anxiety Disorders, and Mood Disorders. In addition, several measures in common were used to assess demographic and clinical characteristics. Results Of the 658 children, 73% were Caucasian and 59% had an IQ >70. The rates of concomitant disorders across studies were: ADHD 81%, ODD 46%, CD 12%, any anxiety disorder 42%, and any mood disorder 8%. Two or more psychiatric disorders were identified in 66% of the sample. Of those who met criteria for ADHD, 50% also met criteria for ODD and 46% for any anxiety disorder. Associations between types of concomitant disorders and a number of demographic and clinical characteristics are presented. Conclusion In this well-characterized sample of treatment-seeking children with ASD, rates of concomitant psychiatric disorders were high and the presence of two or more co-occurring disorders was common. Findings highlight the importance of improving diagnostic practice in ASD and understanding possible mechanisms of comorbidity