Attitudes Surrounding a Community-Based Fitness Intervention at an Urban FQHC

BACKGROUND AND OBJECTIVES: The population surrounding an urban federally qualified health center (FQHC) in Philadelphia has poorer health than Philadelphia overall. Community residents identified aerobics and dance classes as very important services or programs that an FQHC might provide. We sought to measure the impact of participation in a resident physician-led, patient-centered fitness and nutrition class on participants’ attitudes, knowledge, and self-efficacy regarding their health. METHODS: An urban line dancing class and brief healthy eating intervention for adults was held at a YMCA adjacent to a residency-affiliated FQHC weekly for 8 weeks. Pre/postsurveys were administered to assess attitudes and confidence toward physical activity and healthy lifestyles. RESULTS: Participants’ self-assessment of health and levels of physical activity improved. Confidence in performing everyday activities, doing regular exercise and exercising without making symptoms worse increased. A significant decrease in participants’ physical activity gratification was observed. Participants’ confidence improved in reading food labels for health, but confidence in eating a balanced diet did not improve. CONCLUSIONS: A resident-led fitness and nutrition class, tailored to perceived community needs, generated significant interest and sustained participation. This pilot study furthered development of community infrastructure addressing health, nutrition, and overall fitness, and the results reflect opportunities and challenges of engaging communities in physical fitness

Atrial Fibrillation After Cardiac Surgery: An Evidence-Based Approach to Prevention

minority of patients will develop AF. Thus, many patients will be exposed to potential side effects of a treatment when they are at low risk of developing AF. Pharmacologic Prevention Virtually all drugs from every Vaughan-Williams class of antiarrhythmics have been investigated as a means to prevent AF after cardiac surgery. Most trials that have explored class I agents (eg, procainamide, flecainide, and others) have limitations that impede firm conclusions to be drawn about safety and efficacy. 5 In light of the association of these drugs with proarrhythmia in patients with structural heart disease, the use of class I agents for the prevention of AF has not been recently pursued. More attention has been focused on drugs that possess β-blocking properties. Conventional β-Blockers Given the perceived role of heightened sympathetic tone in the development of postoperative AF, there has been great interest in the use of prophylactic β-blockers for patients undergoing cardiac surgery. Multiple trials have consistently shown that β-blockers effectively reduce the frequency of postoperative AF compared with placebo. 9,10 In a recent meta-analysis, β-blockers reduced the frequency of AF from 33% to 19% but with considerable heterogeneity between the trials. 11 These results appear to apply to all formulations, suggesting a class effect. Even when ineffective, the heart rate will be better controlled for patients developing AF when β-blockers are given. Thus, the available data suggest that β-blockers are effective in reducing the frequency of AF after cardiac surgery. Despite the prevalent efficacy data, limitations are common with trials of β-blockers for AF prophylaxis. For example, the trials vary in the use of intermittent electrocardiogram (ECG) monitoring versus continuous ECG monitoring. A di-P ostoperative atrial fibrillation (AF) occurs in 25% to 40% of patients after cardiac surgery. This arrhythmia has been associated with a more complicated postoperative course, increased risk of stroke, increased length of hospital stay, and increased hospital costs. This article focuses primarily on the various options available for the prevention of AF postcardiac surgery. The viewpoint developed is based on a critical assessment of whether existing data provide evidence that a given strategy is effective and safe for widespread implementation. The latter critique is important, given that only a A number of advances in surgical and anesthetic techniques have reduced the risk for patients undergoing cardiac surgery. However, postoperative atrial fibrillation remains common, with an incidence ranging between 25% and 40%. It is associated with an increased incidence of congestive heart failure, renal insufficiency, and stroke that prolongs hospitalization and increases rates of readmission after discharge. Consequently, there has been great interest in strategies to prevent this arrhythmia. When both safety and efficacy are considered, the available evidence to date suggests that only β-blockers can be recommended for the prevention of atrial fibrillation after cardiac surgery. Other treatments might be considered on an individual basis after careful consideration of the patient's potential for side effects

Similarities in drinking behavior of twin's friends: moderation of heritability of alcohol use

Previous research has indicated that friends' drinking may influence alcohol use in adolescents and young adults. We explored whether similarities in the drinking behavior of friends of twins influence the genetic architecture of alcohol use in adolescence and young adulthood. Survey data from The Netherlands Twin Register were available for 1,526 twin pairs aged 16-25 years. We categorized the twin pairs as concordant (both report similar alcohol use in their friends) or discordant for the alcohol use of their friends. Genetic moderator models were tested by carrying out multi-group analyzes in Mplus. Findings showed a significant moderation effect. Genetic factors were more and common environment less important in the explanation of variation in alcohol use in twins discordant for alcohol use of friends than in twins concordant for alcohol use of friend

The Reinforcing Therapist Performance (RTP) experiment: Study protocol for a cluster randomized trial

<p>Abstract</p> <p>Background</p> <p>Rewarding provider performance has been recommended by the Institute of Medicine as an approach to improve the quality of treatment, yet little empirical research currently exists that has examined the effectiveness and cost-effectiveness of such approaches. The aim of this study is to test the effectiveness and cost-effectiveness of providing monetary incentives directly to therapists as a method to improve substance abuse treatment service delivery and subsequent client treatment outcomes.</p> <p>Design</p> <p>Using a cluster randomized design, substance abuse treatment therapists from across 29 sites were assigned by site to either an implementation as usual (IAU) or pay-for-performance (P4P) condition.</p> <p>Participants</p> <p>Substance abuse treatment therapists participating in a large dissemination and implementation initiative funded by the Center for Substance Abuse Treatment.</p> <p>Intervention</p> <p>Therapists in both conditions received comprehensive training and ongoing monitoring, coaching, and feedback. However, those in the P4P condition also were given the opportunity to earn monetary incentives for achieving two sets of measurable behaviors related to quality implementation of the treatment.</p> <p>Outcomes</p> <p>Effectiveness outcomes will focus on the impact of the monetary incentives to increase the proportion of adolescents who receive a targeted threshold level of treatment, months that therapists demonstrate monthly competency, and adolescents who are in recovery following treatment. Similarly, cost-effectiveness outcomes will focus on cost per adolescent receiving targeted threshold level of treatment, cost per month of demonstrated competence, and cost per adolescent in recovery.</p> <p>Trial Registration</p> <p>Trial Registration Number: NCT01016704</p

Analysis of the Initiating Events in HIV-1 Particle Assembly and Genome Packaging

HIV-1 Gag drives a number of events during the genesis of virions and is the only viral protein required for the assembly of virus-like particles in vitro and in cells. Although a reasonable understanding of the processes that accompany the later stages of HIV-1 assembly has accrued, events that occur at the initiation of assembly are less well defined. In this regard, important uncertainties include where in the cell Gag first multimerizes and interacts with the viral RNA, and whether Gag-RNA interaction requires or induces Gag multimerization in a living cell. To address these questions, we developed assays in which protein crosslinking and RNA/protein co-immunoprecipitation were coupled with membrane flotation analyses in transfected or infected cells. We found that interaction between Gag and viral RNA occurred in the cytoplasm and was independent of the ability of Gag to localize to the plasma membrane. However, Gag:RNA binding was stabilized by the C-terminal domain (CTD) of capsid (CA), which participates in Gag-Gag interactions. We also found that Gag was present as monomers and low-order multimers (e.g. dimers) but did not form higher-order multimers in the cytoplasm. Rather, high-order multimers formed only at the plasma membrane and required the presence of a membrane-binding signal, but not a Gag domain (the CA-CTD) that is essential for complete particle assembly. Finally, sequential RNA-immunoprecipitation assays indicated that at least a fraction of Gag molecules can form multimers on viral genomes in the cytoplasm. Taken together, our results suggest that HIV-1 particle assembly is initiated by the interaction between Gag and viral RNA in the cytoplasm and that this initial Gag-RNA encounter involves Gag monomers or low order multimers. These interactions per se do not induce or require high-order Gag multimerization in the cytoplasm. Instead, membrane interactions are necessary for higher order Gag multimerization and subsequent particle assembly in cells

The WD-repeat protein superfamily in Arabidopsis: conservation and divergence in structure and function

BACKGROUND: The WD motif (also known as the Trp-Asp or WD40 motif) is found in a multitude of eukaryotic proteins involved in a variety of cellular processes. Where studied, repeated WD motifs act as a site for protein-protein interaction, and proteins containing WD repeats (WDRs) are known to serve as platforms for the assembly of protein complexes or mediators of transient interplay among other proteins. In the model plant Arabidopsis thaliana, members of this superfamily are increasingly being recognized as key regulators of plant-specific developmental events. RESULTS: We analyzed the predicted complement of WDR proteins from Arabidopsis, and compared this to those from budding yeast, fruit fly and human to illustrate both conservation and divergence in structure and function. This analysis identified 237 potential Arabidopsis proteins containing four or more recognizable copies of the motif. These were classified into 143 distinct families, 49 of which contained more than one Arabidopsis member. Approximately 113 of these families or individual proteins showed clear homology with WDR proteins from the other eukaryotes analyzed. Where conservation was found, it often extended across all of these organisms, suggesting that many of these proteins are linked to basic cellular mechanisms. The functional characterization of conserved WDR proteins in Arabidopsis reveals that these proteins help adapt basic mechanisms for plant-specific processes. CONCLUSIONS: Our results show that most Arabidopsis WDR proteins are strongly conserved across eukaryotes, including those that have been found to play key roles in plant-specific processes, with diversity in function conferred at least in part by divergence in upstream signaling pathways, downstream regulatory targets and /or structure outside of the WDR regions

Development and validation of the Online Histrionic Personality Scale (OHPS) using the DSM-5 criteria for Histrionic Personality Disorder

The present study evaluated personality presentation in online environments in terms of histrionic personality. The aim of the study was to develop the Online Histrionic Personality Scale (OHPS). The OHPS was developed using the diagnostic criteria for histrionic personality disorder (HPD) in the DSM-5 and assesses histrionic behavior in online environments. The present study comprised 381 university students (219 females and 162 males) from four different samples. The validity of the OHPS was investigated utilizing exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and criterion validity. As a result of the EFA, a single-factor structure with an eigenvalue of 3.850 was found and accounted for 48.12% of the total variance. This one-dimensional structure was tested with CFA in two different samples. CFA results show that OHPS had an acceptable fit. The criterion validity of the OHPS was examined with the Desire for Being Liked Scale (DBLS) and the Histrionic Personality Belief subscale of the Personality Belief Questionnaire-Short Form (PBQ-STF). Analysis showed that the OHPS was significantly associated with desire for being liked (r = .65, p < .01) and histrionic personality beliefs (r = .70, p < .01). The reliability of the OHPS was evaluated with Cronbach’s α internal consistency reliability coefficient and corrected item total correlation coefficient in three different samples. The Cronbach α internal consistency coefficients of the OHPS were .84 (EFA sample), .88 (CFA sample), and .88 (criterion validity sample). Corrected item total correlation coefficients of OHPS ranged from .53 to .62 in the EFA sample, .47 to .78 in the CFA sample, and .52 to .76 in the criterion validity sample. The distribution of data was examined with floor and ceiling effects in three different samples. Finally, the standard error of measurement (SEM) was calculated in three different samples. There were no floor and ceiling effects in the data, and the SEM values were within acceptable limits. When validity and reliability analyses of the OHPS are considered as a whole, it is concluded that the OHPS is a valid and reliable scale that assesses online histrionic personality among university students

RNA interference approaches for treatment of HIV-1 infection

HIV/AIDS is a chronic and debilitating disease that cannot be cured with current antiretroviral drugs. While combinatorial antiretroviral therapy (cART) can potently suppress HIV-1 replication and delay the onset of AIDS, viral mutagenesis often leads to viral escape from multiple drugs. In addition to the pharmacological agents that comprise cART drug cocktails, new biological therapeutics are reaching the clinic. These include gene-based therapies that utilize RNA interference (RNAi) to silence the expression of viral or host mRNA targets that are required for HIV-1 infection and/or replication. RNAi allows sequence-specific design to compensate for viral mutants and natural variants, thereby drastically expanding the number of therapeutic targets beyond the capabilities of cART. Recent advances in clinical and preclinical studies have demonstrated the promise of RNAi therapeutics, reinforcing the concept that RNAi-based agents might offer a safe, effective, and more durable approach for the treatment of HIV/AIDS. Nevertheless, there are challenges that must be overcome in order for RNAi therapeutics to reach their clinical potential. These include the refinement of strategies for delivery and to reduce the risk of mutational escape. In this review, we provide an overview of RNAi-based therapies for HIV-1, examine a variety of combinatorial RNAi strategies, and discuss approaches for ex vivo delivery and in vivo delivery