AMERICA'S FORGOTTEN PEOPLE AND PLACES: ENDING THE LEGACY OF POVERTY IN THE RURAL SOUTH

This study focuses on the longstanding impoverishment of the rural South and three of its subregions-Appalachia, the Mississippi Delta, and the Black Belt. The poor quality of life in rural Appalachia and along the Mississippi Delta has been publically acknowledged by programs and commissions for improving conditions. However, the more comprehensive Black Belt subregion that links parts of Southern Appalachia and the Southern Delta has not received such regional policy attention. While the South as a whole is more rural and impoverished than other U.S. regions, this is largely due to the poor conditions in the Black Belt. In addition to region and rurality, a third feature of the pattern is race. It is in the Black Belt that the South's poor socioeconomic conditions are most concentrated. Policy and program attention are needed for regional solutions that take rurality and race into account along with demographic and other subregional characteristics.Appalachia, Black Belt, Mississippi Delta, policy, poverty, quality of life, rural, South, Community/Rural/Urban Development,

A neuraminidase from Trypanosoma cruzi removes sialic acid from the surface of mammalian myocardial and endothelial cells

Trypanosoma cruzi causes Chagasic heart disease, a major public health problem in Latin America. The mechanism of interaction of this protozooan parasite with host cells is poorly understood. We recently found that the infective trypomastigote form a T. cruzi exhibits neuraminidase activity and can desialylate mammalian erythrocytes. However, it is not known if T. cruzi can also modify the surfaces of cardiovascular cells that are directly involved in the most important clinical manifestations of this disease. Accordingly, this study determined whether T. cruzi can remove sialic acid from cultured rat myocardial or human vascular endothelial cells. Sialic acid was labeled metabolically with the precursor 3H-N-acetyl-D-mannosamine. Soluble neuraminidase, isolated from intact T. cruzi trypomastigotes, caused significant release of labeled material from myocardial cells (e.g., 2,174 +/- 27 dpm/h vs. spontaneous release of 306 +/- 30 dpm/h, n = 4, P less than 0.001). Chromatographic analysis showed that the bulk of the radioactivity released by T. cruzi neuraminidase was sialic acid. Intact T. cruzi trypomastigotes also released sialic acid from metabolically labeled myocardial cells in a concentration-dependent manner. In contrast, a noninfective form of T. cruzi, the amastigote, did not desialylate these cells. Galactose oxidase labeling demonstrated newly desialylated glycoproteins on the surface of myocardial cells treated with T. cruzi neuraminidase. Desialylation of myocardial cells was confirmed histochemically by the appearance of binding sites for peanut agglutinin, a lectin that binds to complex oligosaccharide moieties after removal of the terminal sialyl residue. T. cruzi neuraminidase also removed sialic acid from adult human saphenous vein endothelial cells, as determined by both histochemical and metabolic labeling studies. Thus, infective forms of T. cruzi can chemically modify the surfaces of myocardial and vascular endothelial cells by desialylation. This alteration may play a role in the initial interaction of this parasite with these important target cells of the host cardiovascular system

A tale of two therapies lipid-lowering vs. anti-inflammatory therapy : a false dichotomy?

Non peer reviewe

A tale of two therapies lipid-lowering vs. anti-inflammatory therapy : a false dichotomy?

Non peer reviewe

Anticipated regret to increase uptake of colorectal cancer screening (ARTICS):a randomised controlled trial

Objective. Screening is key to early detection of colorectal cancer. Our aim was to determine whether a simple anticipated regret (AR) intervention could increase colorectal cancer screening uptake. Methods. We conducted a randomised controlled trial of a simple, questionnaire-based AR intervention, delivered alongside existing pre-notification letters. 60,000 adults aged 50-74 from the Scottish National Screening programme were randomised to: 1) no questionnaire (control), 2) Health Locus of Control questionnaire (HLOC) or 3) HLOC plus anticipated regret questionnaire (AR). Primary outcome was guaiac Faecal Occult Blood Test (FOBT) return. Secondary outcomes included intention to return test kit and perceived disgust (ICK). Results. 59,366 people were analysed as allocated (Intentionto- treat (ITT)); there were no overall differences between treatment groups on FOBT uptake (control: 57.3%, HLOC: 56.9%, AR: 57.4%). 13,645 (34.2%) people returned questionnaires. Analysis of the secondary questionnaire measures showed that AR had an indirect effect on FOBT uptake via intention, whilst ICK had a direct effect on FOBT uptake over and above intention. The effect of AR on FOBT uptake was also moderated by intention strength: for less than strong intenders only, uptake was 4.2% higher in the AR (84.6%) versus the HLOC group (80.4%) (95% CI for difference (2.0, 6.5)). Conclusion. The findings show that psychological concepts including anticipated regret and perceived disgust (ICK) are important factors in determining FOBT uptake. However, there was no simple effect of the AR intervention in the ITT. We conclude that exposure to AR in those with low intentions may be required to increase FOBT uptake. Current controlled trials: www.controlledtrials. com number: ISRCTN74986452

Non-invasive anatomic and functional imaging of vascular inflammation and unstable plaque

Over the last several decades, basic cardiovascular research has significantly enhanced our understanding of pathobiological processes leading to formation, progression, and complications of atherosclerotic plaques. By harnessing these advances in cardiovascular biology, imaging has advanced beyond its traditional anatomical domains to a tool that permits probing of particular molecular structures to image cellular behaviour and metabolic pathways involved in atherosclerosis. From the nascent atherosclerotic plaque to the death of inflammatory cells, several potential molecular and micro-anatomical targets for imaging with particular selective imaging probes and with a variety of imaging modalities have emerged from preclinical and animal investigations. Yet, substantive barriers stand between experimental use and wide clinical application of these novel imaging strategies. Each of the imaging modalities described herein faces hurdles—for example, sensitivity, resolution, radiation exposure, reproducibility, availability, standardization, or costs. This review summarizes the published literature reporting on functional imaging of vascular inflammation in atherosclerotic plaques emphasizing those techniques that have the greatest and/or most immediate potential for broad application in clinical practice. The prospective evaluation of these techniques and standardization of protocols by multinational networks could serve to determine their added value in clinical practice and guide their development and deploymen

Rights or containment? The politics of Aboriginal cultural heritage in Victoria

Aboriginal cultural heritage protection, and the legislative regimes that underpin it, constitute important mechanisms for Aboriginal people to assert their rights and responsibilities. This is especially so in Victoria, where legislation vests wide-ranging powers and control of cultural heritage with Aboriginal communities. However, the politics of cultural heritage, including its institutionalisation as a scientific body of knowledge within the state, can also result in a powerful limiting of Aboriginal rights and responsibilities. This paper examines the politics of cultural heritage through a case study of a small forest in north-west Victoria. Here, a dispute about logging has pivoted around differing conceptualisations of Aboriginal cultural heritage values and their management. Cultural heritage, in this case, is both a powerful tool for the assertion of Aboriginal rights and interests, but simultaneously a set of boundaries within which the state operates to limit and manage the challenge those assertions pose. The paper will argue that Aboriginal cultural heritage is a politically contested and shifting domain structured around Aboriginal law and politics, Australian statute and the legacy of colonial history

Energize Worcester: Smart Heating Controls in Student HMOs

This project partnered with the University of Worcester to examine the possible social implications and effects of implementing smart heating controls in student-rented houses in multiple occupation (HMOs). Through the use of surveys, our team evaluated student attitudes towards sustainability as well as the potential acceptance and effectiveness that smart heating controls could have in student off-campus housing. Our survey results identified three areas that may complicate the implementation of smart heating controls: insufficient levels of student motivation to improve energy efficiency, the apparent absence of fuel poverty in the population studied, and concerns regarding privacy. We recommend that students be educated on energy expenditure and sustainable practices

Colorectal Cancer Screening and Perceived Disgust:The Importance of the Ick Factor in Faecal Occult Blood Test Uptake

Background: Colorectal cancer is a major cause of cancer deaths worldwide. Screening is key to early detection but uptake of national programmes is poor, especially amongst those from lower socio-economic backgrounds. Decisions not to take up screening may be based more on emotional rather than rational evaluations. We aimed to examine the importance of perceived disgust (the ‘ICK’ factor) in determining colorectal cancer screening uptake, in a large, randomised controlled trial. Methods: This paper reports secondary analysis of a randomised controlled trial of a simple, questionnaire-based Anticipated Regret (AR) intervention, which was delivered alongside existing pre-notification letters. 60,000 adults aged 50- 74 who were participant in the Scottish National Screening programme were randomised to one of 3 treatment arms: 1) no questionnaire (control), 2) Health Locus of Control (HLOC) questionnaire or 3) AR questionnaire. Primary outcome was Faecal Occult Blood Test kit return (FOBT uptake). 13,645 people completed questionnaires of secondary outcomes including intention to return test kit and a new self-report measure of perceived disgust (ICK-C). Results: Intentions, ICK and AR were all predictors of FOBT uptake; however, for people who expressed strong intentions to return their FOBT kit, only ICK differentiated kit returners from non-returners, with non-returners reporting higher disgust (mean difference=0.51; 95% CI for difference (0.37, 0.64), Cohen’s d=0.34). The 4-item ICK-C showed excellent internal reliability and predictive validity with regard to an objective measure i.e., FOBT uptake. Conclusions: The findings show that perceived disgust is an important emotional psychological construct in determining uptake of colorectal cancer screening. We also demonstrated that a simple 4-item scale (the ‘ICK-C), developed to be used in research on colorectal cancer screening, has excellent psychometric properties