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Summary: Background: Obesity prevalence is disproportionately high among Hispanic children. Objectives: The Healthy Families Study assessed the efficacy of a culturally targeted, family‐based weight gain prevention intervention for Hispanic immigrant families with children ages 5–7 years. Methods: The study used a two‐group, cluster randomized trial design, assigning 136 families (clusters) to the active intervention (weight gain prevention) and 136 families to attention control (oral health). The active intervention included a 4‐month intensive phase (eight classes) and an 8‐month reinforcement phase (monthly mail/telephone contact). Children's body mass index z‐score (BMI‐Z) was the primary outcome. Results: The BMI‐Z growth rate of the active intervention group did not differ from the attention control group at short‐term follow‐up (median 6 months; 168 families, 206 children) or long‐term follow‐up (median 16 months; 142 families, 169 children). Dose response analyses indicated a slower increase in BMI‐Z at short term among overweight/obese children who attended more intervention classes. Moderate physical activity on weekends increased at short term. Weekend screen time decreased at short term among those attending at least one class session. Conclusion: Low class attendance likely impacted intention‐to‐treat results. Future interventions targeting this population should test innovative strategies to maximize intervention engagement to produce and sustain effects on weight gain prevention. [ABSTRACT FROM AUTHOR]

The U.S. Preventive Services Task Force recommends that clinicians adopt universal alcohol screening and brief intervention as a routine preventive service for adults, and efforts are underway to support its widespread dissemination. The likelihood that healthcare systems will sustain this change, once implemented, is under-reported in the literature. This article identifies factors that were important to postimplementation sustainability of an evidence-based practice change to address alcohol misuse that was piloted within three diverse primary care organizations. The Centers for Disease Control and Prevention funded three academic teams to pilot and evaluate implementation of alcohol screening and brief intervention within multiclinic healthcare systems in their respective regions. Following the completion of the pilots, teams used the Program Sustainability Assessment Tool to retrospectively describe and compare differences across eight sustainability domains, identify strengths and potential threats to sustainability, and make recommendations for improvement. Health systems varied across all domains, with greatest differences noted for Program Evaluation, Strategic Planning, and Funding Stability. Lack of funding to sustain practice change, or data monitoring to promote fit and fidelity, was an indication of diminished Organizational Capacity in systems that discontinued the service after the pilot. Early assessment of sustainability factors may identify potential threats that could be addressed prior to, or during implementation to enhance Organizational Capacity. Although this study provides a retrospective assessment conducted by external academic teams, it identifies factors that may be relevant for translating evidence- based behavioral interventions in a way that assures that they are sustained within healthcare systems. [ABSTRACT FROM AUTHOR]

During the past few years, several vaccines have been added to the adult immunization schedule. The human papillomavirus (HPV) vaccine is recommended for girls and women aged 11 to 26 years (minimum age, 9 years) to prevent cervical cancer, precancerous or dysplastic lesions, and genital lesions caused by HPV types 6, 11, 16, and 18. The tetravalent meningococcal conjugate vaccine is approved for use in persons 11 to 55 years of age; it produces higher antibody titers 3 years after vaccination than the meningococcal polysaccharide vaccine. The availability of the tetanus, diphtheria, and acellular pertussis vaccine for adults can help reduce the reservoir of pertussis in the general population and thereby decrease transmission to high-risk persons, such as unvaccinated or partially vaccinated infants. The zoster vaccine is recommended for adults 60 years and older; immunization reduces the incidence of herpes zoster and postherpetic neuralgia by more than 50%. [ABSTRACT FROM AUTHOR]

Fibromyalgia is an idiopathic, chronic, nonarticular pain syndrome with generalized tender points. It is a multisystem disease characterized by sleep disturbance, fatigue, headache, morning stiffness, paresthesias, and anxiety. Nearly 2 percent of the general population in the United States suffers from fibromyalgia, with females of middle age being at increased risk. The diagnosis is primarily based on the presence of widespread pain for a period of at least three months and the presence of 11 tender points among 18 specific anatomic sites. There are certain comorbid conditions that overlap with, and also may be confused with, fibromyalgia. Recently there has been improved recognition and understanding of fibromyalgia. Although there are no guidelines for treatment, there is evidence that a multidimensional approach with patient education, cognitive behavior therapy, exercise, physical therapy, and pharmacologic therapy can be effective. [ABSTRACT FROM AUTHOR]

The neuropeptide Y (NPY) receptor subtypes Y[sub 1] and Y[sub 5] are involved in the regulation of feeding and several other physiological functions in mammals. To increase our understanding of the origin and mechanisms of the complex NPY system, we report here the cloning and pharmacological characterization of receptors Y[sub 1] and Y[sub 5] in the first non-mammal, chicken (Gallus gallus). The receptors display 80–83% and 64–72% amino acid sequence identity, respectively, with their mammalian orthologues. The three endogenous ligands NPY, peptide YY (PYY) and pancreatic polypeptide (PP) have similar affinities as in mammals, i.e. NPY and PYY have subnanomolar affinity for both receptors whereas chicken PP bound with nanomolar affinity to Y[sub 5] but not to Y[sub 1]. A notable difference to mammalian receptor subtypes is that the Y[sub 1] antagonist SR120819A does not bind chicken Y[sub 1], whereas BIBP3226 does. The Y[sub 5] antagonist CGP71863A binds to the chicken Y[sub 5] receptor. Anatomically, both Y[sub 1] and Y[sub 5] have high mRNA expression levels in the infundibular nucleus which is the homologous structure of the hypothalamic arcuate nucleus in mammals. These results suggest that some of the selective Y[sub 1] and Y[sub 5] antagonists developed in mammals can be used to study appetite regulation in chicken. [ABSTRACT FROM AUTHOR]

Numerous medical organizations have developed cancer screening guidelines. Faced with the broad, and sometimes conflicting, range of recommendations for cancer screening, family physicians must determine the most reasonable and up-to-date method of screening. Major medical organizations have generally achieved consensus on screening guidelines for breast, cervical and colorectal cancer. For breast cancer screening in women ages 50 to 70, clinical breast examination and mammography are generally recommended every one or two years, depending on the medical organization. For cervical cancer screening, most organizations recommend a Papanicolaou test and pelvic examination at least every three years in patients between 20 and 65 years of age. Annual fecal occult blood testing along with flexible sigmoidoscopy at five-year to 10-year intervals is the standard recommendation for colorectal cancer screening in patients older than 50 years. Screening for prostate cancer remains a matter of debate. Some organizations recommend digital rectal examination and a serum prostate-specific antigen test for men older than 50 years, while others do not. In the absence of compelling evidence to indicate a high risk of endometrial cancer, lung cancer, oral cancer and ovarian cancer, almost no medical organizations have developed cancer screening guidelines for these types of cancer. [ABSTRACT FROM AUTHOR]

In this report, we describe a refinement of the human transcript map of chromosome 1p13.1, a subregion undergoing many aberrations in various types of human cancers. Publicly available genetic linkage, radiation hybrid and physical maps, as well as cytogenetic and sequence data were used to establish the relative order and orientation of ten known intragenic markers. The complete sequence of genomic clones of the region, available at the Sanger Centre, provided the tool for further studies performed by BLAST analysis against all cDNA sequences registered in the Genexpress Index2. This allowed us to assign to subband 1p13.1 nine of the ten known genes, an additional member of the gene family of one of these genes and eleven new transcripts. The remaining known gene and one additional new transcript map at the 1p13.1 and 1p13.2 boundary. The corresponding genes may be responsible for disorders related to this region. The resulting transcript map of 1p13.1 is presented in the printed article with additional data available on a dedicated Web site at the address http://idefix.upr420.vjf.cnrs.fr/CARTO. [ABSTRACT FROM AUTHOR]