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RNA binding proteins (RBPs) play a key role in cellular growth, homoeostasis and survival and are tightly regulated. A deep understanding of their spatiotemporal regulation is needed to understand their contribution to physiology and pathology. Here, we have characterized the spatiotemporal expression pattern of hnRNP A1 and its splice variant hnRNP A1B in mice. We have found that hnRNP A1B expression is more restricted to the CNS compared to hnRNP A1, and that it can form an SDS-resistant dimer in the CNS. Also, hnRNP A1B expression becomes progressively restricted to motor neurons in the ventral horn of the spinal cord, compared to hnRNP A1 which is more broadly expressed. We also demonstrate that hnRNP A1B is present in neuronal processes, while hnRNP A1 is absent. This finding supports a hypothesis that hnRNP A1B may have a cytosolic function in neurons that is not shared with hnRNP A1. Our results demonstrate that both isoforms are differentially expressed across tissues and have distinct localization profiles, suggesting that the two isoforms may have specific subcellular functions that can uniquely contribute to disease progression. [ABSTRACT FROM AUTHOR]

Objective: Individuals who are adherent to their asthma inhaled maintenance medication: (1) initiate their treatment (take the first dose); (2) implement it (take it as per prescribed dosing regimen); and persist with it (take it for the entire prescribing period). To avoid unnecessary hospitalizations and costs, patient adherence should be routinely assessed. To this end, we aimed to identify patient-reported outcome instruments (PROs) used for measurement of patient adherence to inhaled maintenance medication in asthmatic adults and to report on the adherence stage that these instruments measured. Data sources: We conducted a scoping review of six databases. Study selection: We searched for studies in which PROs were used to measure patient adherence to inhaled maintenance medication in asthmatic participants aged ≥18 years. We extracted and synthesized data in order to list the available PROs and to report the adherence stages that these instruments measured. Results: We included 186 studies (87 PROs). Among all 87 instruments, none were found to measure all three adherence stages. We found that 1 measured initiation, 2 evaluated initiation and implementation, 74 assessed implementation, 7 measured implementation and persistence. The most used instrument (n = 41 studies or 22%) was the Self-Reported Medication-Taking Scale, which was found to assess implementation only. Conclusion: Our results suggest that no single PRO exists to measure initiation, implementation and persistence with asthma inhaled maintenance medication. Results from this review could therefore guide the development or refinement of PROs that would aim to measure all three adherence stages. [ABSTRACT FROM AUTHOR]

Background: Spirometry is the best test to demonstrate airway obstruction, but remains underused in primary care. Objectives: We assessed, among family medicine physician teachers and residents, their intention to prescribe spirometry in patients suspected of chronic obstructive pulmonary disease and their intention to interpret the results. This evaluation is based on the theoretical framework proposed by Godin et al. for the study of factors influencing healthcare professionals' behavior. Methods: Participants of this descriptive cross-sectional study were recruited from eight Family medicine units (FMUs) of Laval University's network. They completed a 23-item self-administered questionnaire measuring their intention to prescribe and to interpret spirometry as well as some determinants of this intention (beliefs about capabilities, beliefs about consequences, social influence and moral norm). Answers to each of the items were scored on a Likert scale (score 1 to 7) where a higher score indicated a greater agreement with the statement. Results: Of the 284 eligible physicians, 104 were included. The mean score ± standard deviation of physicians' intention to prescribe spirometry (6.6 ± 0.7) was higher than to interpret the results (5.8 ± 1.5). Mean scores for all determinants of intention measured were also higher for prescription than for interpretation of spirometry. Conclusion: The results suggest that participants have a very strong intention to prescribe spirometry. Although the intention to interpret the results is positive, it is weaker than for the prescription of the test. Further studies will be needed to assess the barriers to spirometry interpretation. [ABSTRACT FROM AUTHOR]

Objective: To assess whether adding a video on atrial fibrillation (AF) to a face-to-face educational session improves quality of life (QoL), knowledge, and health resource utilization (HRU) among AF patients.Methods: In this parallel clinical trial, adults with AF received a face-to-face educational session on AF and were randomly allocated to watch an educational video or not. Self-reported questionnaires measured QoL (primary outcome; score 0-100), AF knowledge (score 0-25), and HRU. Data were collected before and after interventions. Within- and between-group changes were estimated by mixed models.Results: Sixty participants (age: 56 ± 13 years; men: n = 41) were allocated to watch the video after education (n = 30) or to receive education only (n = 30). Within groups over time, QoL and knowledge significantly improved. Knowledge increased by 2.3 units (95% confidence interval: 0.5-4.1) more in participants who watched the video than in others (P = 0.014). Changes in QoL and HRU were not different between groups.Conclusion: Complementing education with a video on AF did not result in additional positive impacts on QoL and HRU among AF adults but led to greater improvements in AF knowledge.Practice Implications: The video on AF could be used as part of educational sessions to increase AF knowledge in AF patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to identify systematically the measurement properties of patient‐reported outcome instruments (PROs) that evaluate adherence to inhaled maintenance medication in adults with asthma. Methods: We conducted a systematic review of six databases. Two reviewers independently included studies on the measurement properties of PROs that evaluated adherence in asthmatic participants aged ≥18 years. Based on the COnsensus‐based Standards for the selection of health Measurement INstruments (COSMIN), the reviewers: (i) extracted data on internal consistency, reliability, measurement error, content validity, structural validity, hypotheses testing, cross‐cultural validity, criterion validity and responsiveness; (ii) assessed the methodological quality of the included studies; (iii) assessed the quality of the measurement properties (positive or negative); and (iv) summarized the level of evidence (limited, moderate or strong). Results: We screened 6068 records and included 15 studies (14 PROs). No studies evaluated measurement error or responsiveness. Based on methodological and measurement property quality assessments, we found limited positive evidence of: (i) internal consistency of the Adherence Questionnaire, Refined Medication Adherence Reason (MAR) scale, Medication Adherence Report Scale for Asthma (MARS‐A) and Test of the Adherence to Inhalers (TAI); (ii) reliability of the TAI; and (iii) structural validity of the adherence questionnaire, MAR scale, MARS‐A and TAI. We also found limited negative evidence of: (i) hypotheses testing of the Adherence Questionnaire; (ii) reliability of the MARS‐A; and (iii) criterion validity of the MARS‐A and TAI. Conclusions: Our results highlighted the need to conduct further high‐quality studies to evaluate the reliability, validity and responsiveness of the available PROs. [ABSTRACT FROM AUTHOR]

Objective: Based on the Knowledge-to-Action Cycle, we assessed the self-reported implementation and perception of asthma clinical practice guideline (CPG) recommendations in primary care physicians (PCPs), along with the barriers and facilitators to CPG use in primary care.Methods: We conducted a cross-sectional study. Using the extendedAsthma Physicians' Practice Assessment Questionnaire©, PCPs self-reported the following: their knowledge of 15 key asthma CPG recommendations, the perceived usefulness of each of these recommendations, their motivation to apply these recommendations, and their agreement with the content of these recommendations. Participants also reported the barriers and facilitators to CPG use in primary care.Results: Out of the 46 potential participants, 43 physicians completed the questionnaire (response rate: 93%). Results underlined care gaps regarding the provision of asthma education and written action plans, inhaler technique demonstrations, and assessment of patients' concerns. Results showed that the majority of physicians knew the key asthma CPG recommendations, but their motivation to implement them and the perceived usefulness of these recommendations varied from one proposal to another. Main barriers to the implementation of these recommendations were related to time and resources. PCPs stressed the importance of teamwork for enhancing the use of asthma CPGs in primary care.Conclusions: Our results suggest that the implementation of asthma CPGs remains suboptimal in primary care. Interventions addressing the identified barriers and providing facilitators to asthma CPG implementation, such as continuing education, could be implemented and evaluated to sustain asthma CPG use in primary care settings. [ABSTRACT FROM PUBLISHER]

Background: Not providing adequate patient education interventions to asthma patients remains a major care gap. To help asthma patients and caregivers discuss inhaled controller medication use, our team has previously developed a decision aid (DA). We sought to assess whether adding this DA to education interventions improved knowledge, decisional conflict, and asthma control among adults with asthma. Methods: A parallel clinical trial (NCT02516449). We recruited adults with asthma, aged 18 to 65 years, prescribed inhaled controller medication to optimize asthma control. Educators randomly allocated participants either to the education + DA or to the education group. At baseline and two-month follow-up, we measured asthma knowledge (primary outcome) with a validated self-administered questionnaire (score –37 to +37). Secondary outcomes included decisional conflict and asthma control. Blinded assessors collected data. Between the two time points, the within- and between-group changes were estimated by generalized linear mixed models. Results: Fifty-one participants (response rate: 53%; age: 44 ± 13 years; women: n = 32) were randomized either to the education + DA group (n = 26) or to the education group (n = 25), and included in statistical analyses. Between baseline and follow-up, mean [95% CI] knowledge scores increased from 21.5 [19.9–23.2] to 25.1 [23.1–27.0] in the education + DA group (P = 0.0002) and from 24.0 [22.3–25.7] to 26.0 [24.0–28.0] in the education group (P = 0.0298). In both of the groups, decisional conflict and asthma control improved. There were no differences between groups. Conclusions: Education improved knowledge, decisional conflict, and asthma control whether the DA was added or not. [ABSTRACT FROM AUTHOR]

Background: Patient decision aids (PDAs) are used in shared decision making to improve practitioner-patient communication and help patients decide about treatment options. To develop a PDA for adults with asthma considering inhaled corticosteroids, with or without long-acting beta2-agonists, to optimize asthma control.Methods: The PDA was developed based on the International Patient Decision Aid Standards. Step 1: PDA was drafted. Step 2: PDA acceptability was assessed among target users, certified asthma educators (CAEs) and adults with asthma, following an iterative process. a) Participants read the PDA, b) rated its presentation, length, balance, and perceived usefulness, indicated what they liked/disliked about it, and made suggestions for improvement. c) Based on results from (b), PDA was refined. This process was repeated with new participants until no suggestions were made. Step 3: The PDA was field tested with target users. Interviews with CAEs were conducted to identify areas of improvement. Step 4: Final PDA version was written.Results: A color-printed, 4-page, letter-sized PDA was drafted. Acceptability testing involved 11 CAEs (women, n = 10) and 20 adults with asthma (women,n= 13; age 22–61 years). Five successive refined versions were produced. Major changes were made to PDA terminology, instructions, paper size, and visual presentation. Two CAEs (women, n = 2) and 26 adults with asthma (women,n= 19; age 20–65 years) field tested PDA. Minor changes were made to language and instructions to ensure usability. The final version was a color-printed, 12-page, A3-sized booklet.Conclusion: Our newly developed PDA was found acceptable and usable in target users. [ABSTRACT FROM AUTHOR]

Objectives: We sought to describe training activities on self-management support (SMS) for asthma educators and the effects of SMS provided by trained educators on asthma patient outcomes.Methods: We conducted a systematic review of six medical databases and sought for trials assessing SMS provided for adults with asthma by trained educators. Two reviewers independently selected and extracted data on asthma educators' training activities and patient outcomes. We performed meta-analyses for asthma-related quality of life (QoL) and asthma control.Results: We screened 3217 records and included 16 trials. Learning activities and assessments were reported in 8/16 and 4/16 trials, respectively. Compared to usual care, trained asthma educators provided SMS that resulted in clinically important improvements in QoL (pooled mean difference [MD] = 0.52; 95% confidence interval [95%CI]: 0.19 to 0.83) and asthma control (pooled MD= -0.68; 95%CI: -0.99 to -0.38).Conclusion: Although asthma-specific SMS provided by trained educators had a beneficial effect over the current care, our results highlight the need to better describe training activities for asthma educators.Practice Implications: This systematic review provides key elements of efficient training activities for asthma educators and reaffirms the importance of training educators to provide SMS in order to improve asthma patients' QoL and asthma control. [ABSTRACT FROM AUTHOR]

Objective: To examine rates of vaccine hesitancy and their correlates among Canadian adults between April 2020 and March 2021., Design: Five sequential cross-sectional age, sex and province-weighted population-based samples who completed online surveys., Setting: Canada., Participants: A total of 15 019 Canadians aged 18 years and over were recruited through a recognised polling firm (Leger Opinion). Respondents were 51.5% female with a mean age of 48.1 (SD 17.2) years (range 18-95 years) and predominantly white (80.8%)., Primary and Secondary Outcome Measures: Rates of vaccine hesitancy over the five surveys (time points) and their sociodemographic, clinical and psychological correlates., Results: A total of 42.2% of respondents reported some degree of vaccine hesitancy, which was lowest during surveys 1 (April 2020) and 5 (March 2021) and highest during survey 3 (November 2020). Fully adjusted multivariate logistic regression analyses revealed that women, those aged 50 and younger, non-white, those with high school education or less, and those with annual household incomes below the poverty line in Canada were significantly more likely to report vaccine hesitancy, as were essential and healthcare workers, parents of children under the age of 18 and those who do not get regular influenza vaccines. Endorsing prevention behaviours as important for reducing virus transmission and high COVID-19 health concerns were associated with 77% and 54% reduction in vaccine hesitancy, respectively. Having high personal financial concerns was associated with 1.33 times increased odds of vaccine hesitancy., Conclusions: Results highlight the importance of targeting vaccine efforts to specific groups by emphasising the outsized health benefits compared with risks of vaccination. Future research should monitor changes in vaccine intentions and behaviour to better understand underlying factors., Competing Interests: Competing interests: KL is a member of the Canadian COVID-19 Expert Advisory Panel (Health Canada); has served on the advisory board or as a consultant for Schering-Plough, Takeda, AbbVie, Almirall, Janssen, GSK, Novartis, Boehringer Ingelheim (BI) and Sojecci; has received sponsorship for investigator-generated research grants from GlaxoSmithKline (GSK) and AbbVie, speaker fees from GSK, Astra-Zeneca, Astellas, Novartis, Takeda, AbbVie, Merck, Boehringer Ingelheim, Bayer, Pfizer, Xfacto and Air Liquide; and has received support for educational materials from Merck, none of which are related to the current article. MV has served on the advisory board for Diabetes Canada and has received sponsorship for investigator-generated research grants from Novo Nordisk, Abbott Diabetes Care and Bausch Health, and consultation and speaker fees from Abbott Diabetes Care, Novo Nordisk, Abbvie, Boehringer Ingelheim and Lifescan, none of which are related to the current article. JP is a member of the Ontario Immunization Advisory Committee (Public Health Ontario) and a member of the Ontario COVID-19 Science Advisory Table. SB is a member of the Health Canada COVID Alert Application Working Group; has served on the advisory board for Bayer and Sanofi; and has received sponsorship for investigator-generated research grants from GSK, Moderna and Abbvie, consultation fees from Schering-Plough, Merck, Astra Zeneca, Sygesa, Bayer, Sanofi, Lucilab and Respiplus, and speaker fees from Novartis, Respiplus and Janssen, none of which are related to the current article., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)