A systematic review of weight-related communication trainings for physicians: What do we know and how can we inform future development of training programs?

It is reported that physicians lack training to address weight-related concerns with patients. To overcome this, training programs have been implemented in medical settings to prepare physicians to have conversations with patients. However, it is unclear the degree of consistency among existing training programs and factors associated with better outcomes. The objective of this study was to systematically review the existing literature in this area to determine differences in content, outcomes, and implementation of existing studies that test weight-related communication training programs for physicians. A systematic literature review of online databases including PubMed, PsycINFO, and Proquest was conducted with the assistance of a librarian. Search terms included: health communication, training, physician training, weight, and obesity. Studies were selected based on the following inclusion criteria: physicians are post-graduate medical doctors; trainings encompassed weight-related communication; and outcomes were tied to physician uptake of skills, knowledge, and self-efficacy, or patient-related outcomes. Two coders reviewed studies using detailed inclusion criteria. Disagreements were resolved by consensus among authors. Half of studies assessed outcomes in both patients and physicians. Trainings including motivational interviewing (MI) assessing patient outcomes found increases in patient knowledge, satisfaction, motivation, and weight loss, respectively. Whereas, non-MI trainings assessing patient outcomes found an increase in patient weight loss, confidence and motivation, or no changes in patient outcomes. This review was the first to examine programs aimed to teach physicians to communicate with patients about weight. Future studies should examine the effect of physician communication on BMI.https://scholarscompass.vcu.edu/gradposters/1025/thumbnail.jp

Reducing Disparities in Smoking for Adults with Mental Illness: Are U.S. Tobacco Prevention Policies Effective?

One in five people in the U.S. are estimated to experience “any mental illness” (AMI); however this group represents an estimated 40% of the annual, adult cigarette consumption in the U.S. Tobacco prevention policies have been successful at reducing smoking prevalence among the U.S. population as a whole, however it is unclear whether these efforts have had significant impact on tobacco use rates among individuals with AMI. The three papers that comprise this project combined longitudinal, nationally-representative data and online behavioral experiments from U.S. adults to compare demand for cigarettes among adult smokers with and without AMI. Taken together, our findings imply that adults with AMI have the potential to have more difficulty reducing combustible tobacco use under certain conditions than adults without these symptoms, making it imperative that this population remain a high priority for investigators seeking to reduce a significant disparity in use rates and combustible tobacco-related health consequences

Does Exposure and Receptivity to E-cigarette Advertisements Relate to E-cigarette and Conventional Cigarette Use Behaviors among Youth? Results from Wave 1 of the Population Assessment of Tobacco and Health Study

Background: E-cigarettes (EC) are the most commonly used tobacco product among youth. Additionally, youth EC users are progressing to smoking conventional cigarettes (CC). Although known to target youth, there are no current restrictions in the US on EC marketing, including advertising. The purpose of this study is to evaluate the relationship between EC advertisements and youth EC and CC use behaviors. Methods: This study analyzed data from youth (12-17 years) aware of EC in Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) study (n=12,199). Weighted logistic regression models assessed whether exposure and receptivity to any of five randomized EC ads (two TV and three print) were associated with the outcomes of EC and CC behaviors of ever use, current (past 30 day) use, and susceptibility to future use. Additional analyses determined whether EC advertising exposure and EC and CC behaviors associations were moderated by EC advertising receptivity. All models were adjusted for sociodemographics, other combustible tobacco product use, and parent smoking. Results: EC advertisement exposure was significantly associated to ever and current EC use as well as susceptibility to EC and CC (p Conclusion: These findings demonstrate exposure to EC advertisements are particularly associated with EC use behaviors, but could play a role in future CC use as well. Youth who are receptive to EC advertisements appear particularly vulnerable. Further studies should focus on the role of receptivity to EC advertisements among youth in order to support regulatory policy targeting EC advertising

CO mapping of the Orion molecular cloud: The influence of star formation on cloud structure

Regions of massive star formation have long been believed to have a profound influence on the structure of their surrounding molecular clouds. The ways in which massive star formation has altered the structure and kinematics of the Orion Molecular Cloud are discussed. The data to be discussed consists of a large scale map of the CO J=1-0 emission from approximately 3 square degrees of OMC-1. During 1985, the Five College Radio Astronomy Observatory 14M antenna was used to map a 2 deg x 1 deg region centered on alpha(1950) = 5(h)33(m)00(s) delta(1950) = -5 deg 30 min. The region mapped in 1985 covers the well known HII regions M42, M43, and NGC1977, and the CO map contains abundant evidence of the interaction between these regions and the molecular cloud. Indeed, the global structure of the cloud appears to have been strongly influenced by the continuous formation of massive stars within the cloud. Individual instances of some of these features are discussed. There appear to be two classes of features which are indicative of this interaction: CO bright rims and CO holes. During 1986, we have undertaken further mapping of OMC-1 to the south of the region covered by the 1985 map. This portion of the cloud contains significant regions of star formation, but O star formation has not occured and large HII regions have not developed to alter the appearance of the cloud. A detailed map of this region is thus an opportunity to view the structure of the molecular cloud before it has been altered by massive star formation. Preliminary analysis of data obtained in this region suggests that the structure and kinematics of the southern portion of the Orion cloud are indeed dramatically different from those of the region previously mapped. Comparison of the two regions thus supports models of the development of structure in molecular clouds through interaction with the HII regions formed within them

Prolactin Induces Tuberoinfundibular Dopaminergic Neurone Differentiation in Snell Dwarf Mice if Administered Beginning at 3 Days of Age

The hypothalamic tuberoinfundibular dopaminergic (TIDA) neurones secrete dopamine, which inhibits prolactin secretion. TIDA neurone numbers are deficient in Ames (df/df) and Snell (dw/dw) dwarf mice, which lack prolactin, growth hormone and thyroid-stimulating hormone. Prolactin therapy initiated before 21 days maintains normal-sized TIDA neurone numbers in df/df mice and, when initiated as early as 7 days, maintains the maximum TIDA neurone numbers observed in dw/dw development, which are decreased compared to those in normal mice. The present study investigated the effect of prolactin dose and species on TIDA neurone development. Snell dwarf and normal mice were treated with saline, 5 μg of ovine prolactin (oPRL), 50 μg of oPRL, or 50 μg of recombinant mouse prolactin (rmPRL) beginning at 3 days of age. Brains were analysed at 45 days using catecholamine histofluorescence, and immunohistochemistry for tyrosine hydroxylase or bromodeoxyuridine. Normal mice had greater (P ≤ 0.01) TIDA neurones than dw/dw, regardless of treatment. TIDA neurones in 50 μg oPRL-treated dw/dw mice were greater (P ≤ 0.05) than those in 5 μg oPRL- and rmPRL-treated dw/dw mice, which were greater (P ≤ 0.01) than those in saline-treated dw/dw mice. Fifty microgram oPRL-treated dw/dw mice also had greater (P < 0.01) TIDA neurone numbers than the maximum numbers observed in untreated dw/dw mice development. Among saline, 5 μg oPRL and 50 μg oPRL treatments, but not rmPRL, A14 neurone numbers were higher (P ≤ 0.01) in normal compared to in dw/dw mice. The mechanism of TIDA neurone recruitment was investigated using bromodeoxyuridine (BrdU) treatment at intervals after 21 days. Mice treated with rmPRL, but not oPRL, had increased BrdU incorporation in the periventricular area surrounding the third ventricle and median eminence and in the arcuate nucleus. The data obtained in the present study indicate that oPRL, but not rmPRL, when given at a high enough dose, induces TIDA neurone differentiation in dw/dw mice. This supports neurotrophic effects of prolactin on TIDA neurones in early postnatal development that extends beyond maintenance of the cell population

Coherent Detector Arrays for Millimeter and Submillimeter Astronomy

Progress in many areas of astronomy requires large-area surveys and observations of extended objects. This includes the cosmic microwave background, nearby galaxies, the Milky Way, and regions of star-forming regions within our galaxy. The ability to carry out such studies is critically dependent on the development of affordable high-sensitivity focal plane arrays, for both spectral line and continuum observations. We discuss a program for the next decade to develop such technology for ground-based and spacebased millimeter and submillimeter astronomy. Appropriate technologies exist, but significant effort is required to make the transition from simply replicating individual pixels to approaching focal plane array design in an integrated fashion from feeds to spectrometers for spectral analysis. This advance is essential to realize the full potential of major new ground-based, suborbital, and future space facilities, and is relevant to the RMS and EOS panels. The recommended budget for this activity is $65M

The State Relationship with Religion:defined through disciplinary procedures of accounting and regulation

State regulation of charities is increasing. Nevertheless, although religious entities also pursue charitable objectives, jurisdictions often regulate them differently. In some states (including England until recently), the church (religious charities) are not called to account for their common-good contribution, despite owning significant assets and receiving public and government income. These regulatory and accounting variations emanate from a state’s historically informed positional relationship with religion, which may be discordant against increasing religious pluralism and citizens’ commonly-held beliefs. To open a debate on state–church relationships within the accounting history literature, this article analyses changes in England since 1534. It utilises a state–church framework from Monsma and Soper, combined with an application and extension of Foucauldian governmentality. The longitudinal study shows direct and indirect governmentality tools change with the state–church relationship. Such harmonisation of regulatory approach relies on citizens/entities subverting imposition of state demands which fail to meet their concept of common-good

Large grains in disks around young stars: ATCA observations of WW Cha, RU Lup, and CS Cha

Grains in disks around young stars grow from interstellar submicron sizes to planetesimals over the course of several Myr. Thermal emission of large grains or pebbles can be best observed at cm wavelengths. However, other emission mechanisms can contribute. We aim to determine the mechanisms of cm emission for 3 T Tauri stars. WW Cha and RU Lup were recently found to have grain growth at least up to mm sizes in their circumstellar disks. CS Cha has similar indications for grain growth in its circumbinary disk. The T Tauri stars WW Cha and RU Lup were monitored over several years at mm and cm wavelengths, using ATCA. The new ATCA 7 mm system was also used to observe CS Cha. WW Cha was detected on several occasions at 7 and 16 mm. We obtained one detection of WW Cha at 3 cm and upper limits only at 6 cm. The emission at 16 mm was stable over days, months and years, but the emission at 3 cm is found to be variable. RU Lup was detected at 7 mm. It was observed at 16 mm 3 times and at 3 and 6 cm 4 times and found to be variable in all 3 wavebands. CS Cha was detected at 7 mm, but the S/N was too low to resolve the gap in the circumbinary disk. The emission at 3, 7 and 16 mm for WW Cha is well explained by thermal emission from mm and cm-sized pebbles. The cm spectral index is consistent with the emission from an optically-thick ionised wind, but the high variability of the cm emission points to a non-thermal contribution. The SEDs of RU Lup and CS Cha from 1 to 7 mm are consistent with thermal emission from mm-sized grains. The variability of the longer-wavelength emission for RU Lup and the negative spectral index suggest non-thermal emission.Comment: 11 pages, 7 tables, 8 figures, accepted by Astronomy and Astrophysic

Leukocytes mediate disease pathogenesis in the Ndufs4(KO) mouse model of Leigh syndrome

Symmetric, progressive, necrotizing lesions in the brainstem are a defining feature of Leigh syndrome (LS). A mechanistic understanding of the pathogenesis of these lesions has been elusive. Here, we report that leukocyte proliferation is causally involved in the pathogenesis of LS. Depleting leukocytes with a colony-stimulating factor 1 receptor inhibitor disrupted disease progression, including suppression of CNS lesion formation and a substantial extension of survival. Leukocyte depletion rescued diverse symptoms, including seizures, respiratory center function, hyperlactemia, and neurologic sequelae. These data reveal a mechanistic explanation for the beneficial effects of mTOR inhibition. More importantly, these findings dramatically alter our understanding of the pathogenesis of LS, demonstrating that immune involvement is causal in disease. This work has important implications for the mechanisms of mitochondrial disease and may lead to novel therapeutic strategies