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Background: Approximately one-half of all adults with HIV experience chronic pain. Needed are nonpharmacological approaches to improve pain management in this population. Methods: For this study, we conducted in-depth qualitative interviews (n = 20) with thirteen adults with HIV and 7 HIV care providers regarding their perceptions of Tai Chi for chronic pain management. The interviews were audio recorded, transcribed, double-coded, and analyzed using applied thematic analysis. Results: HIV patients had limited prior exposure to Tai Chi and had not previously considered this practice for pain management. However, after viewing a brief video demonstration of Tai Chi, patients recognized potential benefits, including relaxation, stress reduction, and pain lessening. Patients were surprised by the gentle nature of Tai Chi and expressed enthusiasm to learn more about Tai Chi. HIV healthcare providers similarly had limited knowledge of Tai Chi for pain management. HIV care providers shared several helpful insights on the potential implementation of Tai Chi with this population. Conclusions: Adults with HIV and healthcare providers were optimistic that Tai Chi would reduce stress and ease chronic pain. These data suggest that Tai Chi would be of interest to HIV patients and care providers as a novel pain management strategy. [ABSTRACT FROM AUTHOR]

Stages of change measure an individual's readiness to alter a health behavior. This study examined the latent longitudinal patterns of stages of change (SoC) for regular exercise over time among individuals participating in a lifestyle intervention project. It also investigated the association between the longitudinal patterns of SoC and intervention outcomes using a new statistical method to assess the relationship between latent class membership and distal outcomes. We analyzed data from the Special Diabetes Program for Indians Diabetes Prevention Program, a lifestyle intervention program to prevent diabetes among American Indians and Alaska Natives. Latent class analysis (LCA) was conducted to identify the longitudinal patterns of SoC for regular exercise reported at three time points. LCA with distal outcomes was performed to investigate the associations between latent class membership and behavioral changes after the intervention. The parameters and standard errors of the LCA with distal outcomes models were estimated using an improved three-step approach. Three latent classes were identified: Pre-action, Transition, and Maintenance classes. The Transition class, where stage progression occurred, had the greatest improvements in physical activity and weight outcomes at both time points post-baseline among female participants. It also had the largest improvements in weight outcomes among male participants. Furthermore, the Pre-action class had more attenuation in the improvements they had achieved initially than the other two classes. These findings suggest the potential importance of motivating participants to modify their readiness for behavioral change in future lifestyle interventions.

The regulation of autophagy-dependent lysosome homeostasis in vivo is unclear. We showed that the inositol polyphosphate 5-phosphatase INPP5K regulates autophagic lysosome reformation (ALR), a lysosome recycling pathway, in muscle. INPP5K hydrolyzes phosphatidylinositol-4,5-bisphosphate [PI(4,5)[P.sub.2]] to phosphatidylinositol 4-phosphate [PI(4)P], and INPP5K mutations cause muscular dystrophy by unknown mechanisms. We report that loss of INPP5K in muscle caused severe disease, autophagy inhibition, and lysosome depletion. Reduced PI(4,5)[P.sub.2] turnover on autolysosomes in Inpp5K muscle suppressed autophagy and lysosome repopulation via ALR inhibition. Defective ALR in InppSkmyoblasts was characterized by enlarged autolysosomes and the persistence of hyperextended reformation tubules, structures that participate in membrane recycling to form lysosomes. Reduced disengagement of the PI(4,5)[P.sub.2] effector clathrin was observed on reformation tubules, which we propose interfered with ALR completion. Inhibition of PI(4,5)[P.sub.2] synthesis or expression of WT INPP5K but not INPP5K disease mutants in INPP5K-depleted myoblasts restored lysosomal homeostasis. Therefore, bidirectional interconversion of PI(4)P/PI(4,5)[P.sub.2] on autolysosomes was integral to lysosome replenishment and autophagy function in muscle. Activation of TFEB-dependent de novo lysosome biogenesis did not compensate for loss of ALR in InppSkmuscle, revealing a dependence on this lysosome recycling pathway. Therefore, in muscle, ALR is indispensable for lysosome homeostasis during autophagy and when defective is associated with muscular dystrophy., Introduction Autophagy is a fundamental catabolic and cytoprotective process. During autophagy, multiple lysosomes fuse with autophagosomes to form autolysosomes in which cellular debris is degraded (1). Lysosomes are critical for [...]

The Kessler Screening Scale for Psychological Distress (K6; Kessler et al., 2002) has been used widely as a screener for mental health problems and as a measure of severity of impact of mental health problems. However, the applicability and utility of this measure for assessments within American Indian communities has not been explored. Data were drawn from a large-scale epidemiological study conducted in cooperation with 2 American Indian populations. Participants (N = 3,084) were 15-54 years of age and living on or near their home reservations; each completed an interview that included a version of the Composite International Diagnostic Interview (Robins, Wing, Wittchen, & Helzer, 1988) and the K6. A measure of both physical- and mental-health-related quality of life--the Medical Outcome Study's Short Form-36 (Ware & Sherbourne, 1992)--was used to examine the importance of the K6 over and above psychiatric diagnoses. The K6 was shown to be an appropriate screening and severity measure for mood disorders in these 2 samples. It also predicted health-related quality of life over and above that predicted by diagnoses alone. Inclusion of a measure such as the K6 as a complement to more traditional dichotomous diagnoses in both research and clinical practice is recommended. (Contains 4 figures and 3 tables.)

Children who begin kindergarten with stronger skills learn faster than do those who enter with lower skills. Minority children tend to enter kindergarten already at a disadvantage, and the gap widens across time. However, little is known about cognitive development among American Indian young children. In this study, 110 American Indian infants from one Northern Plains reservation community were assessed four times between ages 6 months and 36 months, with the Mullen Scales of Early Learning. At 6 months of age, scores were near the national norms; a drop occurred between 6 months and 15 months. Scores then tended to level off below the norms through 36 months. In each domain, we observed a crucial decline over the 1st year of life and relatively little change in the 2nd and 3rd years of life, highlighting the importance of developing culturally syntonic interventions to facilitate cognitive development during the 1st year of life. (Contains 6 figures and 1 table.)

Early childhood teachers and educational programs are expected to be the primary resources as children experience different and sometimes conflicting cultural contexts. Early educators can play a paramount role as young children move through fluid identities and start recognizing and navigating within and across spaces of cultural differences--e.g., between home cultures and the socially-dominant school culture. In this sense, we draw attention to a multi-year action research study, paying particular attention to the process whereby an early childhood teacher investigated, problematized, and challenged the nature of curriculum and practices in a diverse preschool classroom. We focus on the role of action research in fostering culturally-relevant teaching. As we do so, we analyze an early childhood teacher's shifting perceptions of what it means to engage in culturally-relevant teaching, respecting and honoring cultural diversities.

Approximately 3 million teens are diagnosed with a sexually transmitted disease (STD) annually; STDs rates for American Indian young adults are among the highest of any racial/ethnic group. An important risk factor for STDs is early initiation of sex. In this study, we examined risk for early initiation with 474 American Indian youth ages 14-18, using 11 risk factors from three developmentally important microsystems (family, school, peers) along with several individual characteristics; a cumulative risk index was also calculated. Discrete-time survival analyses showed that predictors of early initiation differed by gender. For young men, younger initiation of sex was predicted by lower grades, liking school less, having peers with less prosocial attitudes, a greater likelihood of having used alcohol or drugs at first sex, and having higher sensation-seeking. For young women, earlier initiation was related to having mothers who had their first child at an early age and who had less formal education, to having parents who had divorced, dropping out of high school, using alcohol/drugs at first sex, and higher sensation-seeking. Higher cumulative risk was associated with elevated risk of sexual initiation, although the degree of added risk varied with age for women. Cumulative risk deserves broader attention in understanding the early initiation of sexual intercourse.