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No recent national data on expenditures and utilization are available to provide a benchmark for reform of mental health systems for children and adolescents. The most recent estimates, from 1986, predate the dramatic growth of managed care. This study provides updated national estimates. Treatment expenditures are estimated to be $11.68 billion ($172 per child). Adolescents have the highest expenditures at $293 per child followed by $163 per child aged 6 to 11 and $35 per preschool-aged child. Outpatient services account for 57%, inpatient for 33%, and psychotropic medications for 9% of the total. Unlike earlier reports, outpatient care now accounts for the majority of expenditures. This finding replicates the differences between recent managed care data and earlier actuarial databases for privately insured adults and confirms the trend from inpatient toward outpatient care. [ABSTRACT FROM AUTHOR]

Home health aides face a range of stressors that may result in departing the workforce. One stressor that has emerged in multiple qualitative studies as potentially influencing retention is client death. Using 2019 data from a single agency in New York City employing approximately 1700 aides, we used logistic and linear regression to explore case and aide factors associated with workforce outcomes after client death. We found that longer case length (Beta = 0.01, p <.001) was associated with longer return to work for aides experiencing client death and longer job tenure (Beta = −0.002, p =.002) was associated with shorter return to work (n = 67). We found no difference in retention between aides who experienced client death and those who did not (n 216). This analysis suggests the importance of research on the period of time following client death and of offering support to aides after clients die, particularly after longer cases. [ABSTRACT FROM AUTHOR]

In patients with heart failure (HF), self‐care, and caregiver contribution to self‐care (i.e., the daily management of the disease by patients and caregivers) are essential for improving patient outcomes. However, patients and caregivers are often inadequate in their self‐care and contribution to self‐care, respectively, and struggle to perform related tasks. Face‐to‐face motivational interviewing (MI) effectively improves self‐care and caregiver contribution to self‐care, but the evidence on remote MI is scarce and inconclusive. The aims of this randomized controlled trial will be to evaluate whether remote MI performed via video call in patients with HF: (1) is effective at improving self‐care maintenance in patients (primary outcome); (2) is effective for the following secondary outcomes: (a) for patients: self‐care management, self‐care monitoring, and self‐efficacy; HF symptoms; generic and disease‐specific quality of life; anxiety and depression; use of healthcare services; and mortality; and (b) for caregivers: contribution to self‐care, self‐efficacy, and preparedness. We will conduct a two‐arm randomized controlled trial. We will enroll and randomize 432 dyads (patients and their informal caregivers) in Arm 1, in which patients and caregivers will receive MI or, in Arm 2, standard care. MI will be delivered seven times over 12 months. Outcomes will be assessed at baseline and 3 (primary outcome), 6, 9, and 12 months from enrollment. This trial will demonstrate whether an inexpensive and easily deliverable intervention can improve important HF outcomes. With the restrictions on in‐person healthcare professional interventions imposed by the COVID‐19 pandemic, it is essential to evaluate whether MI is also effective remotely. [ABSTRACT FROM AUTHOR]

Self‐care performed by patients and the caregiver contribution to this self‐care are essential for improving cardiovascular outcomes; however, so far, no studies have sufficiently investigated this field in Italy. This paper describes a research protocol of a multi‐center longitudinal study designed to investigate the self‐care of patients affected by coronary heart disease (CHD), the caregiver's contribution to this self‐care, the predictors of patient and caregiver self‐care, the mediating role of self‐efficacy, and the self‐care outcomes. Data collection will be performed across seven Italian inpatient settings at baseline and 3 and 6 months from enrollment. Multilevel modeling and actor partner interdependence models will be implemented on a sample of 330 patient–caregiver dyads to adjust for the interdependence of measurements. The study received approval from an ethics committee in Italy and was financed in January 2021 by a grant from the Solidal Foundation in Alessandria. This research will advance the knowledge about the self‐care process in CHD. The results will guide research and clinical practice by identifying variables sensitive to educational interventions. [ABSTRACT FROM AUTHOR]

Introduction: Despite increased focus on development of mental health services worldwide, many adolescents still hesitate to reach out to the services when they need them. This might be linked to the lack of adolescent involvement in the development of services. This study aimed to explore adolescents' perspectives on the ideal healthcare services to meet their mental health needs. Methods: A two‐stage qualitative study was carried out to explore the perspectives of adolescents on the healthcare services to support their mental health. In the first stage, data from 295 adolescents attending a mental health seminar were analysed using qualitative content analysis. In the second stage, in‐depth perspectives of 10 adolescent coresearchers were gathered through self‐reflection and group discussions to further explore the categories developed in the first stage. Thematic analysis was used to develop the themes answering the research question. Ten adolescent coresearchers planned the study, collected and analysed data and authored the manuscript, with the support of a senior researcher. Results: Five themes describe adolescents' perspectives on the ideal healthcare services to meet their mental health needs: (1) Culturally Sensitive and Responsive; (2) Communication of Information; (3) Easy Access; (4) Variety of Support; and (5) Consistency. Culturally Sensitive and Responsive services influenced all other themes. The themes describe suggestions for mental health service improvement, including how to manage the barriers that adolescents face to receive help from the mental health services. Discussion: This study highlights the importance of culturally sensitive and responsive services. It raises the need for an expanded definition of culture going beyond nationality and ethnic background. Adolescents need flexible services that meet their individual mental health needs. This has implications for practitioners, educators, system organizers and researchers, who should also involve adolescents in planning, implementing and assessing the services. There is a need for a self‐learning system to continuously adapt to user feedback. Conclusion: This study provides insight into adolescents' perspectives on the ideal mental health services. It offers suggestions for ways to improve services to better meet the individual mental health needs of adolescents. Additional research is needed to further develop and implement service changes, as well as to assess their acceptability, effectiveness, cost‐effectiveness and safety. Patient or Public Contribution: This is a study lead by adolescents. Adolescent coresearchers have, with the support of a senior researcher, planned and carried out the study, collected and analysed data and authored the manuscript. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the factorial invariance of the Counseling Center Assessment of Psychological Symptoms–62 (CCAPS-62) across military background and gender identity. A sample of 2,208 military students and 2,208 nonmilitary students were chosen from a large database of university and college counseling centers. Using exploratory structural equation modeling, findings suggested the CCAPS-62 is mostly invariant across military background and gender identity. Only three item thresholds appeared to be noninvariant across groups. These results suggest comparisons of scores across military background and gender can be made. Latent mean differences across groups were also examined. After controlling for several background variables, there were some differences between males and females on subscales measuring depression, eating concerns, and generalized anxiety, but no differences between military and nonmilitary students. Implications for practice and future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Diffuse hemispheric glioma H3 G34-mutant (G34-DHG) is a new type of pediatric-type diffuse high-grade glioma in the fifth edition of the WHO Classification of Tumors of the Central Nervous System. The current treatment for G34-DHG involves a combination of surgery and conventional radiotherapy or chemotherapy; however, the therapeutic efficacy of this approach is not satisfactory. In recent years, molecular targeted therapy and immunotherapy have achieved significant benefits in a variety of tumors. In-depth understanding of molecular changes and immune infiltration in G34-DHGs will help to establish personalized tumor treatment strategies. Here, we report the clinicopathological, molecular and immune infiltration characteristics of G34-DHG cases from our center along with cases from the HERBY Trial and the Chinese Glioma Genome Atlas database (CGGA).Methods: Hematoxylin-eosin (HE) and immunohistochemistry (IHC) staining were used to present the clinicopathological characteristics of 10 Chinese G34-DHG patients treated at our institution. To address the molecular characteristics of G34-DHG, we performed whole-exome sequencing (WES) and RNA sequencing (RNA-seq) analyses of 5 patients from our center and 3 Chinese patients from the Chinese Glioma Genome Atlas (CGGA) database. Additionally, 7 European G34-DHG patients from the HERBY Trail were also subjected to analyses, with 7 cases of WES data and 2 cases of RNA-seq data. Six G34-DHG patients from another organization were used as external validation.Results: WES showed a high frequency of PDGFRA mutation in G34-DHGs (12/15). We further identified frequent mutations in MUC family genes in G34-DHGs, including MUC16 (8/15) and MUC17 (8/15). Although no statistical difference was found, PDGFRA mutation tended to be an indicator for worse prognosis whereas MUC16/MUC17 mutation indicated a favorable prognosis in G34-DHGs. RNA sequencing results revealed that most G34-DHG are considered to be immune cold tumors. However, one patient in our cohort with MUC16 mutation showed significant immune infiltration, and the total overall survival of this patient reached 75 months.Conclusions: Our results demonstrate that G34-DHG is a new high-grade glioma with high frequency of PDGFRA and MUC gene family mutations. PDGFRA may serve as an indicator of poor prognosis and an effective therapeutic target. Moreover, MUC16 tends to be a favorable prognostic factor and indicates high immune infiltration in certain patients, and these findings may provide a new direction for targeted therapy and immunotherapy of patients with G34-DHGs. [ABSTRACT FROM AUTHOR]

Barriers to health care access can greatly affect one's health status. Research shows that U.S. adults with intellectual and developmental disabilities (IDD) have poor health and face barriers such as long waits for appointments. However, whether barriers differ by race and ethnicity has not been examined. We conducted a secondary data analysis using the 2002-2011 Medical Expenditure Panel Survey dataset, and compared perceived barriers of community-living U.S. adults with IDD in three racial and ethnic groups (White, Black, and Latinx). Specifically, we examined the top reasons for not having usual source of care, delaying or foregoing medical care. For Black and Latinx adults with IDD, the most-mentioned reasons for not having usual source of care, delaying or foregoing medical care were "don't like/don't trust doctors," "don't use doctors," and "don't know where to get care." In comparison, the White adults with IDD group's biggest perceived barriers were location and insurance related. All groups cited that being unable to afford care was a top reason for delaying or foregoing care. Policies/interventions to improve health care access in racial/ethnic minorities with IDD must first address the topic of developing trust between patients and the health professions. Insurance and the rising costs of care are also key areas that need attention. [ABSTRACT FROM AUTHOR]

Objective: To develop a model for identifying clinic performance at fulfilling next-day and walk-in requests after adjusting for patient demographics and risk.Data Source: Using Department of Veterans Affairs (VA) administrative data from 160 VA primary care clinics from 2014 to 2017.Study Design: Using a retrospective cohort design, we applied Bayesian hierarchical regression models to predict provision of timely care, with clinic-level random intercept and slope while adjusting for patient demographics and risk status. Timely care was defined as the provision of an appointment within 48 hours of any patient requesting the clinic's next available appointment or walking in to receive care.Data Collection/extraction Methods: We extracted 1 841 210 timely care requests from 613 263 patients.Principal Findings: Across 160 primary care clinics, requests for timely care were fulfilled 86 percent of the time (range 83 percent-88 percent). Our model of timely care fit the data well, with a Bayesian R2 of .8. Over the four years of observation, we identified 25 clinics (16 percent) that were either struggling or excelling at providing timely care.Conclusion: Statistical models of timely care allow for identification of clinics in need of improvement after adjusting for patient demographics and risk status. VA primary care clinics fulfilled 86 percent of timely care requests. [ABSTRACT FROM AUTHOR]

The concept of historical trauma (HT) is compelling: Colonialism has set forth cumulative cycles of adversity that promote morbidity and mortality at personal and collective levels, with especially strong mental health impacts. Yet as ongoing community-based as well as scholarly discussions attest, lingering questions continue to surround HT as a framework for understanding the relationships between colonialism and indigenous mental health. Through an overview of 30 recent peer-reviewed publications that aim to clarify, define, measure, and interpret how HT impacts American Indian and Alaska Native (AIAN) mental health, this paper examines how the conceptual framework of HT has circulated in ways shaped by interactions among three prominent research approaches: evidence-based, culturally relevant, and decolonizing. All define current approaches to AIAN mental health research, but each sets forth different conceptualizations of the connections between colonialism and psychological distress. The unfolding trajectory of research about HT reflects persistent tensions in how these frameworks interact, but also possibilities for better integrating them. These considerations aim to advance conversations about the politics of producing knowledge about AIAN mental health, and support ongoing calls for greater political pluralism in mental health research. [ABSTRACT FROM AUTHOR]

This study examined factors associated with treatment engagement and child outcomes in 1,365 children receiving community-based services for exposure to violence. Data were collected on children and families who completed an intake interview. Children were categorized into groups based on whether they attended any therapy sessions after the intake, terminated prematurely from therapy, or completed treatment. Results demonstrated that child emotional and behavioral problems at intake, general parent stress, and income did not differ by treatment engagement. Type of violence exposure, parent–child stress, and race differed by category of treatment engagement. Strategies from Safe From the Start service providers to increase treatment engagement are included in the discussion. [ABSTRACT FROM AUTHOR]

This report explores the extent to which sociodemographic and psychosocial factors could explain differences in obesity or dietary and exercise behaviors between middle-aged African American (AA) and European American (EA) women seen in primary care. We focus on 'race × predictor' interactions that could explain how AA and EA women differ in ways that affect the prevalence of obesity. This comparative exploratory study uses data from the baseline examination of the Reasonable Eating and Activity to Change Health (REACH) trial, which included 173 AA women and 278 EA women. Inclusion criteria were membership in one of the study family medicine practices, an elevated body mass index (greater than 27 kg/m), age 40 to 69 years, and no contraindications to increased activity and dietary change. Secondary data analyses were employed. There was evidence of race differences in the level of multiple variables related to weight management but there were only three significant 'race × predictor' interactions out of 48 comparisons: (a) race × physical health, with BMI as the dependent variable; (b) race × the percentage of dietary fat, with total dietary kilocalories as the dependent variable; and (c) race × median income, with exercise minutes per week as the dependent variable. The results support the proposition that the weight management experience of AA and EA primary care women is similar after different exposure levels are taken into account. The results contribute to the body of literature that addresses obesity management for AA and EA women in primary care settings. Findings illustrate the need for obesity prevention and management efforts from both multidisciplinary primary care providers and community-wide public health interventions. AA and EA women have different resources, but the same factors generally influence weight management, whether one is AA or EA. This suggests that clinical interventions and public health interventions for AA and EA women can be designed around the same principles while paying attention to relevant cultural issues. [ABSTRACT FROM AUTHOR]

MUC4 is a large, heavily glycosylated transmembrane mucin, that is implicated in the pathogenesis of various types of cancers. To date, no extensive study has been done to check the expression and functional significance of MUC4 in different types of gastric adenocarcinomas. Here, we report the expression profile of MUC4 in gastric adenocarcinomas and its function in poorly differentiated gastric non-signet ring cell carcinoma (non-SRCC) type cells. Immunohistochemical analysis using tissue microarray (TMA) showed a significant difference in MUC4 expression between normal adjacent (n = 45) and gastric adenocarcinoma (n = 83; P < 0.001). MUC4 expression was not associated with tumour type, stage or with the degree of differentiation. To gain further insight into the significance of MUC4 expression in gastric non-SRCC cells, MUC4 was ectopically expressed in AGS, a poorly differentiated gastric non-signet ring cell line. The MUC4 overexpressing cells (AGS-MUC4) showed a significant increase (P < 0.005) in cell motility and a decrease in cellular aggregation as compared with the vector-transfected cells. Furthermore, in vivo tumorigenicity analysis revealed that animals transplanted with the MUC4 overexpressing cells (AGS-MUC4) had a greater incidence of tumours (83%) in comparison to empty vector control (17%). In addition, the expression of MUC4 resulted in enhanced expression of total cellular ErbB2 and phosphorylated ErbB2. In conclusion, our results showed that MUC4 is overexpressed in gastric adenocarcinoma tissues, and that it has a role in promoting aggressive properties in poorly differentiated gastric non-SRCC cells through the activation of the ErbB2 oncoprotein. [ABSTRACT FROM AUTHOR]

The mucin MUC4 is a high molecular weight transmembrane glycoprotein. It consists of a mucin-type subunit (MUC4alpha) and a transmembrane growth factor-like subunit (MUC4beta). The mucin MUC4 is overexpressed in many epithelial malignancies including ovarian cancer, suggesting a possible role in the pathogenesis of these cancers. In this study, we investigated the functional role of MUC4 in the human ovarian cancer cell line SKOV3. The mucin MUC4 was ectopically expressed by stable transfection, and its expression was examined by western blot and confocal microscopy analyses. The in vitro studies demonstrated an enhanced motility of MUC4-expressing SKOV3 cells compared with the vector-transfected cells. The mucin MUC4 expression was associated with apparent changes in actin organisation, leading to the formation of microspike, lammelopodia and filopodia-like cellular projections. An enhanced protein expression and activation of HER2, a receptor tyrosine kinase, was also seen, although no significant change was observed in HER-2 transcript levels in the MUC4-transfected SKOV3 cells. Reciprocal co-immunoprecipitation revealed an interaction of MUC4 with HER2. Further, the MUC4-overexpressing SKOV3 cells exhibited an increase in the phosphorylation of focal adhesion kinase (FAK), Akt and ERK, downstream effectors of HER2. Taken together, our findings demonstrate that MUC4 plays a role in ovarian cancer cell motility, in part, by altering actin arrangement and potentiating HER2 downstream signalling in these cells. [ABSTRACT FROM AUTHOR]

Background: Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider organizations in Ontario, Canada. Methods: A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. Results: There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use -- access, assess, adapt, and apply -- research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. Conclusion: These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence. [ABSTRACT FROM AUTHOR]

Several lines of evidence, including familial aggregation, suggest that allelic variation contributes to risk of diabetic nephropathy. To assess the evidence for specific susceptibility genes, we used the transmission/disequilibrium test (TDT) to analyze 115 candidate genes for linkage and association with diabetic nephropathy. A comprehensive survey of this sort has not been undertaken before. Single nucleotide polymorphisms and simple tandem repeat polymorphisms located within 10 kb of the candidate genes were genotyped in a total of 72 type 1 diabetic families of European descent. All families had at least one offspring with diabetes and end-stage renal disease or proteinuria. As a consequence of the large number of statistical tests and modest P values, findings for some genes may be false-positives. Furthermore, the small sample size resulted in limited power, so the effects of some tested genes may not be detectable, even if they contribute to susceptibility. Nevertheless, nominally significant TDT results (P < 0.05) were obtained with polymorphisms in 20 genes, including 12 that have not been studied previously: aquaporin 1; B-cell leukemia/lymphoma 2 (bcl-2) proto-oncogene; catalase; glutathione peroxidase 1; IGF1; laminin alpha 4; laminin, gamma 1; SMAD, mothers against DPP homolog 3; transforming growth factor, beta receptor II; transforming growth factor, beta receptor III; tissue inhibitor of metalloproteinase 3; and upstream transcription factor 1. In addition, our results provide modest support for a number of candidate genes previously studied by others. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate whether diabetic patients carrying the Arg(972) insulin receptor substrate-1 (IRS-1) variant are at increased risk for secondary failure to sulfonylurea.Research Design and Methods: A total of 477 unrelated Caucasian type 2 diabetic patients were recruited according to the following criteria: onset of diabetes after age 35 years, absence of ketonuria at diagnosis, and anti-GAD(-) antibody. Type 2 diabetes was diagnosed according to the American Diabetes Association criteria. Patients with secondary sulfonylurea failure were defined as those requiring insulin due to uncontrolled hyperglycemia (fasting plasma glucose >300 mg/dl) despite sulfonylurea-metformin combined therapy, appropriate diet, and absence of any conditions causing hyperglycemia.Results: Of the total patients, 53 (11.1%) were heterozygous for the Arg(972) IRS-1 variant, 1 (0.2%) was homozygous, and the remainder (88.7%) were homozygous for the wild-type allele. The genotype frequency of the Arg(972) IRS-1 variant was 8.7% among diabetic patients well controlled with oral therapy and 16.7% among patients with secondary failure to sulfonylurea (odds ratio 2.1 [95% CI 1.18-3.70], P = 0.01). Adjustment for age, sex, BMI, metabolic control, age at diagnosis, duration of diabetes, and Pro12Ala polymorphism of peroxisome proliferator-activated receptor-gamma2 gene in a logistic regression analysis with secondary failure to sulfonylurea as a dependent variable did not change this association (2.0 [1.38-3.86], P = 0.038).Conclusions: These data demonstrate that the Arg(972) IRS-1 variant is associated with increased risk for secondary failure to sulfonylurea, thus representing a potential example of pharmacogenetics in type 2 diabetes. [ABSTRACT FROM AUTHOR]

This article presents a study on the use of TNF-α converting enzyme(TACE)-induced cleavage of NgR and p75NTR to disinhibit dorsal root ganglion outgrowth and to promote branching in the presence of inhibitory central nervous system myelin extracts. The study found that related receptor TROY is not subject to fragmentation. The addition of TACE increases the number of dorsal root ganglion neurons neurite branching. Conclusions of the study are given.

Apoptosis and necroptosis are major forms of regulated cell death (10). Necroptosis involves in part molecules also found to regulate apoptosis but depends on the formation of the necrosome, consisting [...], Metastasis is the leading cause of cancer-related death in humans. It is a complex multistep process during which individual tumour cells spread primarily through the circulatory system to colonize distant organs (1-3). Once in the circulation, tumour cells remain vulnerable, and their metastatic potential largely depends on a rapid and efficient way to escape from the blood stream by passing the endothelial barrier (4-9). Evidence has been provided that tumour cell extravasation resembles leukocyte transendothelial migration (7-9). However, it remains unclear how tumour cells interact with endothelial cells during extravasation and how these processes are regulated on a molecular level. Here we show that human and murine tumour cells induce programmed necrosis (necroptosis) of endothelial cells, which promotes tumour cell extravasation and metastasis. Treatment of mice with the receptor-interacting serine/threonineprotein kinase 1 (RIPKl)-inhibitor necrostatin-1 or endothelial-cell-specific deletion of RIPK3 reduced tumour-cell-induced endothelial necroptosis, tumour cell extravasation and metastasis. In contrast, pharmacological caspase inhibition or endothelial-cell-specific loss of caspase-8 promoted these processes. We furthermore show in vitro and in vivo that tumour-cell-induced endothelial necroptosis leading to extravasation and metastasis requires amyloid precursor protein expressed by tumour cells and its receptor, death receptor 6 (DR6), on endothelial cells as the primary mediators of these effects. Our data identify a new mechanism underlying tumour cell extravasation and metastasis, and suggest endothelial DR6-mediated necroptotic signalling pathways as targets for anti-metastatic therapies.

Rates of alcohol use and alcohol use disorder (AUD) vary with geographic location. Research on risks for AUD associated with living in a rural versus urban setting is complicated by [...]

Alcohol use and misuse account for 3.3 million deaths every year, or 6 percent of all deaths worldwide. The harmful effects of alcohol misuse are far reaching and range from [...]

Introduction Maternal smoking during pregnancy is a serious and preventable risk factor that is associated with poor pregnancy outcomes. In the United States, measures of both infant morbidity and mortality [...], Poor pregnancy and birth outcomes are major problems in the United States, and maternal smoking during pregnancy has been identified as one of the most preventable risk factors associated with these outcomes. This study examines less explored risk factors of smoking among underserved African American pregnant women. A cross-sectional survey was conducted at an outpatient obstetrics-gynecology clinic of an inner-city university hospital in Virginia from March 2009 through January 2011 in which pregnant women (N = 902) were interviewed at their first prenatal care visit. Survey questions included items related to women&apos;s sociodemographic characteristics as well as their pregnancy history; criminal history; receipt of social services; child protective services involvement; insurance status; and history of substance abuse, domestic violence, and depression. Multiple logistic regression was conducted to calculate odds ratios and 95% confidence intervals depicting the relationship between these factors and smoking during pregnancy. The analysis reported that maternal age [OR = 1.08, 95% CI = 1.05-1.12], less than high school education [OR = 4.30, 95% CI = 2.27-8.14], unemployed [OR = 2.33, 95% CI = 1.35-4.04], criminal history [OR = 1.66, 95% CI = 1.05-2.63], receipt of social services [OR = 2.26, 95% CI = 1.35-3.79] alcohol use [OR = 2.73, 95% CI = 1.65-4.51] and illicit drug use [OR = 1.97, 95% CI = 1.044-3.74] during pregnancy were statistically significant risk factors associated with smoking during pregnancy. In addition to the well known risk factors, public health professionals should be aware that criminal history and receipt of social services are important factors associated with smoking during pregnancy. Social service providers such as WIC and prisons and jails may offer a unique opportunity for education and cessation interventions during the preconception or interconception period. Keywords Smoking during pregnancy * Correlates of smoking * Criminal history * Social services * Preconception health

Social work's person-in-environment perspective requires that practitioners consider the social and physical environment--its problems, supports, and opportunities--and, specifically, individuals' goodness of fit with it. Yet the development of models for [...], This article reviews recent theory and research on geographic disparities in mental health and their implications for social work. It focuses on work emerging from the fields of mental health geography, psychiatric epidemiology, and social work, arguing that a wide range of spatial disparities in mental health are important to understand but that of greatest relevance are inequities, or disparities, that violate fundamental norms of fairness and social justice. Research is reviewed on geographic variations in subjective well-being and mental health, on personality (using the five-factor model), and on psychopathology as well as several studies on the disparate implementation of mental health policy and services. Critical is the need to simultaneously assess, on the one hand, differential patterns of mental health conditions and, on the other, the services and policies designed to address them-the fact that considering only one dimension often leads to unintended consequences. Many of the most outstanding disparities have been found to exist at the local level, between towns and neighborhoods, and are based on socioeconomic conditions. This review concludes by discussing the implications of geographic disparities in mental health for allocation decisions and for social work practice, including decisions about the most efficacious mix of services at both the community and clinical practice levels. KEY WORDS: geography of mental health; health disparities; quality of life; spatiality; subjective well-being

Introduction Non-small cell lung cancer (NSCLC) is a major health problem worldwide (Alberg and Samet 2003). Surgery is the only potential curative treatment, despite the fact that most patients undergoing [...], Non-small cell lung cancer (NSCLC) is a major health problem. Surgery is the only potential curative treatment, in spite of the high recurrence and mortality rates. Low molecular weight heparins (LMWH) have been suggested to have a positive impact on the outcome of various cancers, mainly attributed to their anticoagulant properties; yet a direct antineoplastic effect has not been excluded. We thought to evaluate the direct effect of the LMWH enoxaparin on the human lung adenocarcinomic epithelial cell line A549 and to determine potential antiproliferative and antimetastatic effects that could guide future trials. A549 cells were cultured with different concentrations of enoxaparin (1-30 U/mL). Cell counting was performed at 24, 48, and 72 h. Detection of c-Myc protein and CD44 protein was performed by electrophoresis and Western blotting. Statistical analysis was performed using paired Student's t tests. Cell counts were decreased with increasing concentrations and time of exposure to enoxaparin. This corresponds to decreased expression of c-Myc and CD44. In conclusion, enoxaparin displayed a direct dose and exposure duration dependent suppressor effect on A549 cell proliferation and the expression of both c-Myc and CD44 in vitro, suggesting reduced proliferative and metastatic potentials of these cells. Key words: CD44, c-Myc, low molecular weight heparins, non-small cell lung cancer, A549 cell line, pulmonary adenocarcinoma, lung cancer. Le cancer du poumon non a petites cellules (CPNPC) constitue un probleme de sante majeur. La chirurgie est le seul traitement curatif possible, malgre les hauts taux de recurrence et de mortalite. Les heparines de bas poids moleculaire (HBPM) pourraient avoir un impact sur revolution de divers cancers, en raison principalement de leurs proprietes anticoagulantes, bien qu'on ne puisse exclure un effet direct antineoplasique. Nous avons eu pour objectif d'evaluer l'effet direct de l'HBPM enoxaparine sur la lignee de cellules A549 issues d'adenocarcinomes de poumon humain et de determiner les effets antiproliferatifs et antimetastatiques qui pourraient guider les futures etudes. Nous avons cultive les cellules A549 avec differentes concentrations d'enoxaparine (1-30 U/mL), et effectue la numerotation des cellules a 24, 48 et 72 h. Nous avons detecte les proteines c-Myc et CD44 par electrophorese et transfert Western, et realise l'analyse statistique par un test t pour echantillons apparies. Les numerotations des cellules ont diminue avec l' augmentation des concentrations et du temps d' exposition a l'enoxaparine, ceci allant de pair avec la diminution de l'expression de c-Myc et CD44. Ainsi, l'enoxaparine a un effet suppresseur dependant de la dose et de la duree d'exposition sur la proliferation des cellules A549 et l'expression de c-Myc et de CD44 in vitro, ce qui autorise a penser a une diminution des potentiels proliferatif et metastatique de ces cellules. Mots-cles : CD44, c-Myc, heparines de bas poids moleculaire, cancer du poumon non a petites cellules, lignee cellulaire A549, adenocarcinome bronchique, cancer du poumon. [Traduit par la Redaction]

In addition to increasing beverage taxes or prices as a means to reduce alcohol accessibility, policymakers also may limit alcohol availability through laws and regulations that (1) proscribe sales to [...]

It has been widely recognized that an epidemiological study limited to individual risk factors will not be adequate to address the current public health challenges of human immunodeficiency virus (HIV)/acquired [...]

Adolescents are facing a growing array of socioemotional and mental health issues. Marsh (2004) notes, for instance, that approximately 4.5 to 6.3 million children and adolescents in the United States [...], Approximately 4.5 to 6.3 million youth experience serious emotional disturbances. Unfortunately, many of them have unmet mental health needs. Tools used in personality assessment can offer unparalleled assistance in diagnosis, and assist in designing appropriate interventions. Unfortunately, not all psychologists embrace personality assessment as a key component in conducting a comprehensive psychological evaluation. In this article the effective use of personality assessment tools is described, with particular attention to issues of comorbidity. Guidelines for effective practice are also offered.

During the past few decades, social gerontologists have debated the compression of morbidity thesis (Quadagno, 2002). This debate was initiated in 1980 by James Fries, a physician teaching at Stanford [...]

Hypertensive disease can lead to cardiac hypertrophy and heart failure and is a major cause of death in developed countries. The heart failure that follows prolonged hypertension is characterized by [...], Cardiac hypertrophy and heart failure caused by high blood pressure were studied in single myocytes taken from hypertensive rats (Dahl SS/Jr) and SH-HF rats in heart failure. Confocal microscopy and patch-clamp methods were used to examine excitation-contraction (EC) coupling, and the relation between the plasma membrane calcium current ([I.sub.Ca]) and evoked calcium release from the sarcoplasmic reticulum (SR), which was visualized as 'calcium sparks.' The ability of [I.sub.Ca] to trigger calcium release from the SR in both hypertrophied and failing hearts was reduced. Because [I.sub.Ca] density and SR calcium-release channels were normal, the defect appears to reside in a change in the relation between SR calcium-release channels and sarcolemmal calcium channels. Β-adrenergic stimulation largely overcame the defect in hypertrophic but not failing heart cells. Thus, the same defect in EC coupling that develops during hypertrophy may contribute to heart failure when compensatory mechanisms fail.

1. Introduction Peroxisome proliferator-activated receptor gamma (PPARG) gene is a member of nuclear hormone receptor superfamily, and it regulates the transcription of several genes involved in glucose metabolism, adipocyte differentiation, [...], Peroxisome proliferator-activated receptor gamma polymorphisms have been widely associated with type 2 diabetes, although their role in the pathogenesis of vascular complications is not yet demonstrated. In this study, a cohort of 211 type 2 diabetes, 205 obese, and 254 control individuals was genotyped for Pro12Ala, C1431T, C-2821T polymorphisms, and for a newly identified polymorphism (A-2819G). The above-mentioned polymorphisms were analyzed by gene-specific PCR and direct sequencing of all samples. A significant difference was found for -2819G frequency when patients with type 2 diabetes--particularly diabetic women with the proliferative retinopathy--were compared with healthy control individuals. In conclusion, we identified a novel polymorphism, A-2819G, in PPARG gene, and we found it to be associated with type 2 diabetes and proliferative retinopathy in diabetic females. In the analyzed population, this variant represents a genetic risk factor for developing the diabetic retinopathy, whereas Pro12Ala and C1431T do not. Copyright [C] 2009 Valerio Costa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How do you get a perfect sphere to acquire a front and back, right-hand and left-hand sides? Such is the challenge addressed during oogenesis, when the molecular signals that initiate [...]