BE YOUR OWN BOSS: A CHRONIC DISEASE SELF-MANAGEMENT PROGRAM

poster abstractObjective: Describe the pilot of a peer-led chronic disease self-management workshop for youth aged 13-24 years old. Background: Fifteen to eighteen percent of children in the United States live with a chronic health condition (Perrin et al., Journal of the American Medical Association 2007, 297:2755). The Stanford chronic disease self-management program (CDSMP) has demonstrated improved self-care and health outcomes in older adults. Alberta Health Services has adapted this program from Stanford University for youth and young adults. CYACC is col-laborating with Alberta to evaluate the effectiveness of the adapted version in adolescents and young adults. Methods: Train the trainer sessions were completed to develop an initial cadre of lay leaders to implement the workshop sessions. Participants with any chronic condition attend 2 hour peer-led sessions once per week for six weeks. During the sessions, individuals with a variety of chronic diseases learn the skills needed in self-management of their condition and mainte-nance of general well-being and life’s activities. Data is collected on self-efficacy, pain, adherence, and other outcomes through pre- and post- as-sessment surveys. Results: Fourteen individuals participated in the pilot phase of the pro-gram; 5 in Lafayette, IN and 8 in Indianapolis, IN. A total of 14 pre-surveys were collected, while 10 post-surveys were collected. Analyses of the sur-veys show beneficial topics , while also indicating which topics should receive additional focus. Areas of the program identified as needing attention include recruitment, risk management, transportation issues, participant dropout rates, logistics of workshops, continued training of lay leaders, and stand-ardization of survey responses. Conclusion: The pilot study identified the importance and need for a self-management program for youth and young adults with chronic conditions. This program has the potential to improve health and self-management in the study population. Limitations of the program were addressed and will be improved for the next round of workshops

Investigation of a hepatitis A outbreak in children in an urban slum in Vellore,Tamil Nadu, using geographic information systems

Background & objectives: An outbreak of symptomatic viral hepatitis in children less than 10 yr of age in Vellore, south India, was investigated and the disease pattern studied using serological and epidemiological methods, supplemented by geographic information systems (GIS) mapping. Methods: Three cases of hepatitis A were identified during routine surveillance in a birth cohort House-to-house visits were undertaken to identify other symptomatic cases and samples collected for anti- HAV IgM, ELISA testing. All cases and controls were mapped and geo-referenced using Arc View GIS 3.3. Spatial clustering was investigated using SaTScan 7.0.1 software. Drinking water sources were tested for coliform counts with the most probable number technique. Results: Of the 965 children surveyed, 26 (2.78%) had jaundice between February to July 2006. From the 26 patients, 11 (42.3%) blood samples were obtained and tested for anti-HAV IgM; 10 (90.9%) were found to be positive. Water analysis showed high coliform counts in all samples. No spatial clustering of cases could be detected. Interpretation & conclusions: The outbreak was identified because of the symptomatic presentation of the cases. Our study highlighted the increasing detection of symptomatic children with hepatitis A virus infection. Water sources in the area were contaminated and may have served as the source of infection. The lack of clustering in GIS analysis could be due to the common water source

Time of life as it is in LiFeAs

The time of life of fermionic quasiparticles, the distribution of which in the momentum-energy space can be measured by angle resolved photoemission (ARPES), is the first quantity to look for fingerprints of interaction responsible for the superconducting pairing. Such an approach has been recently used for superconducting cuprates, but its direct application to pnictides was not possible due to essential three-dimensionality of the electronic band structure and magnetic ordering. Here, we report the investigation of the quasiparticle lifetime in LiFeAs, a non-magnetic stoichiometric superconductor with a well separated two-dimensional band. We have found two energy scales: the lower one contains clear fingerprints of optical phonon modes while the higher scale indicates a presence of strong electron-electron interaction. The result suggests that LiFeAs is a phonon mediated superconductor with strongly enhanced electronic density of states at the Fermi level.Comment: reevaluated electron-phonon coupling strength, added reference

Critical temperature and giant isotope effect in presence of paramagnons

We reconsider the long-standing problem of the effect of spin fluctuations on the critical temperature and isotope effect in a phonon-mediated superconductor. Although the general physics of the interplay between phonons and paramagnons had been rather well understood, the existing approximate formulas fail to describe the correct behavior of $$ for general phonon and paramagnon spectra. Using a controllable approximation, we derive an analytical formula for $T_{c}$ which agrees well with exact numerical solutions of the Eliashberg equations for a broad range of parameters. Based on both numerical and analytical results, we predict a strong enhancement of the isotope effect when the frequencies of spin fluctuation and phonons are of the same order. This effect may have important consequences for near-magnetic superconductors such as MgCNi$_{3}$Comment: 5 pages, 2 figure

Anatomic Demarcation by Positional Variation in Fibroblast Gene Expression Programs

Fibroblasts are ubiquitous mesenchymal cells with many vital functions during development, tissue repair, and disease. Fibroblasts from different anatomic sites have distinct and characteristic gene expression patterns, but the principles that govern their molecular specialization are poorly understood. Spatial organization of cellular differentiation may be achieved by unique specification of each cell type; alternatively, organization may arise by cells interpreting their position along a coordinate system. Here we test these models by analyzing the genome-wide gene expression profiles of primary fibroblast populations from 43 unique anatomical sites spanning the human body. Large-scale differences in the gene expression programs were related to three anatomic divisions: anterior-posterior (rostral-caudal), proximal-distal, and dermal versus nondermal. A set of 337 genes that varied according to these positional divisions was able to group all 47 samples by their anatomic sites of origin. Genes involved in pattern formation, cell-cell signaling, and matrix remodeling were enriched among this minimal set of positional identifier genes. Many important features of the embryonic pattern of HOX gene expression were retained in fibroblasts and were confirmed both in vitro and in vivo. Together, these findings suggest that site-specific variations in fibroblast gene expression programs are not idiosyncratic but rather are systematically related to their positional identities relative to major anatomic axes