Therapists’ Perceptions of School-based Mental Health Services: A Qualitative Evaluation of two Behavioral Health Models

Therapists’ perceptions of school-based mental health programs are considered to be an important factor in determining the effectiveness of a school based behavioral health model. This qualitative evaluation summarizes the perceptions of participant therapists on two different behavioral health models called Full Service Schools (FSS) and Full-Service Schools (FSS) Plus model that are currently being implemented in a large school district in Florida. FSS therapists provide therapy at a hub location whereas FSS Plus therapists work at one particular school. The study utilizes therapists’ views of their respective programs to compare and contrast the effectiveness of each of the behavioral health models. Five focus groups involving 24 therapists from both models were held at five separate locations. Nvivo version 10 was used to conduct a thematic analysis of collected data. Study findings revealed better results for the FSS Plus model as compared to the FSS model in terms of successful elimination of barriers such as transportation and lack of physical space to provide therapy. This study suggests that improved and effective behavioral health services can be provided to students by assigning a designated therapist at each school

Know Your Audience: Designing a Nutrition Education Game for Middle School Kids

Purpose: In recent years video games have emerged as potential tools to tackle obesity. Games that use motion-sensing controllers and interfaces are often used to promote physical activity. Games are also used to impart education about diet, nutrition and health. Our goal in this project is to address childhood obesity through the design, development and implementation of a video game to teach nutrition concepts to middle-school-aged children. Method: Our target audience is middle-school students in a low-income neighborhood in Dallas. To guide us in the game design, we collected data about students’ gaming preferences through surveys, focus groups and student critiques of existing games. The survey addressed students’ choice of gaming platform and frequency of game play. Through focus groups we explored their gaming preferences and opinions on game features. For the critiques, students played nutrition-themed games from the “Apps for Healthy Kids” competition and completed an open-ended survey about those games. Results: We collected data from 76 students (ages 12 – 15 years). 72% of them play games regularly (at least once a week) on consoles while 73% play on portable devices, 68% on computers and 62% play browser-based games. Console games were preferred by 89% of boys but only 56% of girls. The numbers were 81% & 66% for portable devices, but almost the same for computer games and browser-based games. Students preferred action games, games that allowed character customization and games that had multiple levels. Several students are turned off by strong depictions of violence. Students liked the nutrition themed games, but only one game really engaged them. They wanted the food in these games to look real and wanted more familiar food choices. Conclusions: Our observations and height and weight data indicate that malnutrition rather than obesity is likely a bigger problem for these children. Consoles and portable devices were the platforms of choice although there are differences by gender. The results also provide insights into what is likely to work for this audience in terms of game mechanics and game features. The results also reinforce the need for using multiple approaches to collecting data

Middle School Students’ Understanding of Calories, Energy Expenditure and the Nutrition Facts Panel

TORC Abstrac

Expanding the diversity of mycobacteriophages: insights into genome architecture and evolution.

Mycobacteriophages are viruses that infect mycobacterial hosts such as Mycobacterium smegmatis and Mycobacterium tuberculosis. All mycobacteriophages characterized to date are dsDNA tailed phages, and have either siphoviral or myoviral morphotypes. However, their genetic diversity is considerable, and although sixty-two genomes have been sequenced and comparatively analyzed, these likely represent only a small portion of the diversity of the mycobacteriophage population at large. Here we report the isolation, sequencing and comparative genomic analysis of 18 new mycobacteriophages isolated from geographically distinct locations within the United States. Although no clear correlation between location and genome type can be discerned, these genomes expand our knowledge of mycobacteriophage diversity and enhance our understanding of the roles of mobile elements in viral evolution. Expansion of the number of mycobacteriophages grouped within Cluster A provides insights into the basis of immune specificity in these temperate phages, and we also describe a novel example of apparent immunity theft. The isolation and genomic analysis of bacteriophages by freshman college students provides an example of an authentic research experience for novice scientists

Association between arterial stiffness and peripheral artery disease as measured by radial artery tonometry

ObjectiveArterial stiffness and peripheral artery disease (PAD) are both associated with an elevated risk of major adverse cardiac events; however, the association between arterial stiffness and PAD is less well characterized. The goal of this study was to examine the association between parameters of radial artery tonometry, a noninvasive measure of arterial stiffness, and PAD.MethodsWe conducted a cross-sectional study of 134 vascular surgery outpatients (controls, 33; PAD, 101) using arterial applanation tonometry. Central augmentation index (AIX) normalized to 75 beats/min and peripheral AIX were measured using radial artery pulse wave analysis. Pulse wave velocity was recorded at the carotid and femoral arteries. PAD was defined as symptomatic claudication with an ankle-brachial index of <0.9 or a history of peripheral revascularization. Controls had no history of atherosclerotic vascular disease and an ankle-brachial index ≥0.9.ResultsAmong the 126 participants with high-quality tonometry data, compared with controls (n = 33), patients with PAD (n = 93) were older, with higher rates of hypertension, hyperlipidemia, diabetes, and smoking (P < .05). Patients with PAD also had greater arterial stiffness as measured by central AIX, peripheral AIX, and pulse wave velocity (P < .05). In a multivariable model, a significantly increased odds of PAD was associated with each 10-unit increase in central AIX (odds ratio, 2.1; 95% confidence interval, 1.1-3.9; P = .03) and peripheral AIX (odds ratio, 1.9; 95% confidence interval, 1.2-3.2; P = .01). In addition, central and peripheral AIX were highly correlated (r120 = 0.76; P < .001).ConclusionsIn a cross-sectional analysis, arterial stiffness as measured by the AIX is independently associated with PAD, even when adjusting for several atherosclerotic risk factors. Further prospective data are needed to establish whether radial artery tonometry could be a tool for risk stratification in the PAD population

Leptinemia is Associated With Peripheral Artery Disease

BackgroundLeptin, adiponectin, and resistin are in a class of hormones called adipokines that are produced by adipocytes and have been implicated in the causal pathway of atherosclerosis. We examined the association between adipokine levels and peripheral artery disease (PAD), hypothesizing that after adjusting for fat mass, leptin and resistin would be higher, whereas adiponectin would be lower, in patients with PAD.MethodsA cross-sectional sample of 179 predominately male (97%) vascular surgery outpatients was recruited from the San Francisco Veterans Affairs Medical Center (SFVAMC). PAD was defined as either an ankle-brachial index < 0.9 plus symptoms of claudication or prior revascularization for symptomatic PAD (n = 141). Controls had an ankle-brachial index ≥0.9 and no history of atherosclerotic disease (n = 38). Adipokines were assayed using commercially available ELISA kits and values were log-transformed. Fat mass was measured using bioelectrical impedance.ResultsIn an analysis adjusting for body mass index (BMI) and atherosclerotic risk factors, higher serum leptin was associated with PAD (OR 2.54, 95% CI 1.07-6.01, P = 0.03), whereas high molecular weight adiponectin was inversely associated, though not significantly (OR 0.60, 95% CI 0.33-1.08, P = 0.09). Resistin was not associated with PAD. Sensitivity analyses using fat mass/height2 rather than BMI yielded similar results.ConclusionsThese results indicate that after adjusting for BMI or fat mass, serum leptin levels are positively and independently associated with PAD, whereas high molecular weight adiponectin might be inversely associated. Using a more representative, nonveteran sample, further investigations should focus on the potential role of adipokines in the pathophysiology of PAD as well as determine whether leptin levels have clinical utility in predicting PAD outcomes

Peripheral Artery Disease Is Associated with a Deficiency of Erythrocyte Membrane n‐3 Polyunsaturated Fatty Acids

Population-based data suggest that individuals who consume large dietary amounts of n-3 polyunsaturated fatty acids (PUFA) have lower odds of peripheral artery disease (PAD); however, clinical studies examining n-3 PUFA levels in patients with PAD are sparse. The objective of this study is to compare erythrocyte membrane fatty acid (FA) content between patients with PAD and controls. We conducted a cross-sectional study of 179 vascular surgery outpatients (controls, 34; PAD, 145). A blood sample was drawn and the erythrocyte FA content was assayed using capillary gas chromatography. We calculated the ratio of the n-3 PUFA eicosapentaenoic acid (EPA) to the n-6 PUFA arachidonic acid (ARA) as well as the omega-3 index (O3I), a measure of erythrocyte content of the n-3 PUFA, EPA, and docosahexaenoic acid (DHA), expressed as a percentage of total erythrocyte FA. Compared with controls, patients with PAD smoked more and were more likely to have hypertension and hyperlipidemia (p < 0.05). Patients with PAD had a lower mean O3I (5.0 ± 1.7% vs 6.0 ± 1.6%, p < 0.001) and EPA:ARA ratio (0.04 ± 0.02 vs 0.05 ± 0.05, p < 0.001), but greater mean total saturated fats (39.5 ± 2.5% vs 38.5 ± 2.6%, p = 0.01). After adjusting for several patient characteristics, comorbidities, and medications, an absolute decrease of 1% in the O3I was associated with 39% greater odds of PAD (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.03-1.86, and p = 0.03). PAD was associated with a deficiency of erythrocyte n-3 PUFA, a lower EPA:ARA ratio, and greater mean total saturated fats. These alterations in FA content may be involved in the pathogenesis or development of poor outcomes in PAD