Genomics education for health educators in Texas: the Family Health History Training Program

AIMS

This paper describes the development and pilot-testing of The Family Health History Training Program for Health Educators (FHHTP). Although in recent years professional organizations have urged the health promotion workforce to adopt genomics-related competencies, training opportunities designed specifically for health educators (HEs) remain scarce. Designed by a team of HEs, the FHHTP aims at preparing HEs in the state of Texas, USA, to use a family health history as a genomic health promotion tool.

METHODS

In this report, we describe (a) the program's empirical and theoretical grounding, (b) its components, and (c) pilot-testing of the 2 main components (Web-based and workshop trainings). The FHHTP addresses the training needs expressed by HEs and anchors itself in a theoretical model previously tested with 1,607 US-based HEs. The model draws from Social Cognitive Theory, the Theory of Planned Behavior, and Diffusion of Innovations theory. The program comprises 6 elements; the Web-based training and the training workshops are the focus of this paper.

RESULTS

Pilot data indicate participants' knowledge and intention improved significantly (p < 0.05) at post-test and remained significantly higher at the 3-month follow-up. Attitudes, self-efficacy, behavior, knowledge/awareness, and intention also exhibited improvement in scores over time.

CONCLUSION

We conclude, therefore, that the FHHTP can contribute significantly to the adoption of genomic competencies by Texas HEs. This report describes how the first-of-its-kind genomics training for HEs in the USA - FHHTP - was developed and pilot-tested with HEs in Texas.

Evaluation of the packaging and encapsulation reliability in fully integrated, fully wireless 100 channel Utah Slant Electrode Array (USEA): Implications for long term functionality

The encapsulation and packaging reliability in fully integrated, fully wireless 100 channel Utah Slant Electrode Array (USEA)/integrated neural interface-recording version 5 (INI-R5) has been evaluated by monitoring the extended long term in-vitro functional stability and recording longevity. The INI encapsulated with 6-μm Parylene-C was immersed in phosphate buffer saline (PBS) at room temperature for a period of over 12 months. The USEA/INI-R5, while being soaked was powered and configured wirelessly through 2.765 MHz inductive link and the transmitted frequency shift keying (FSK) modulated radio-frequency (RF) (900 MHz Industrial, scientific, medical-ISM band) signal was also recorded wirelessly as a function of soak time. In order to test the long term recording ability, in-vitro wireless recording was performed in agarose for few channels. The full functionality and the ability of the electrodes to record artificial neural signals even after 12 months of PBS soak provides a measure of encapsulation reliability, the functional and recording stability in fully integrated wireless neural interface and potential usefulness for future chronic implants.

Long term in vitro functional stability and recording longevity of fully integrated wireless neural interfaces based on the Utah Slant Electrode Array

We evaluate the encapsulation and packaging reliability of a fully integrated wireless neural interface based on a Utah Slant Electrode Array/integrated neural interface-recording version 5 (USEA/INI-R5) system by monitoring the long term in vitro functional stability and recording longevity. The INI encapsulated with 6 µm Parylene-C was immersed in phosphate buffered saline (PBS) for a period of over 276 days (with the monitoring of the functional device still ongoing). The full functionality (wireless radio-frequency power, command and signal transmission) and the ability of the electrodes to record artificial neural signals even after 276 days of PBS soaking with little change (within 14%) in signal/noise amplitude constitute a major milestone in long term stability and allow us to study and evaluate the encapsulation reliability, functional stability and its potential usefulness for a wireless neural interface for future chronic implants.

The optimal tumor response assessment in patients with HCC after treatment of TACE

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Background: WHO or RECIST has been considered as suboptimal methods for tumor response assessment in HCC, especially receiving locoregional therapies. Recently, new modified methods having concept of viable tumor has been proposed. Herein we compared the efficacy to assess response and to predict prognosis between WHO, RECIST, EASL, mRECIST in HCC patients receiving TACE.

Methods: We retrospectively reviewed 141 HCC patients who were newly diagnosed and received TACE between August 2005 and November 2006. Among them, 98 patients who were available for assessing treatment response were analyzed at 1 month after 2nd TACE. We evaluated intermethod aggreement between methods and assessed the efficacy predicting time to progression (TTP) and overall survival (OS).

Results: The results of tumor responses (number of CR/ PR/ SD/ PD) by WHO/ RECIST/ EASL/ mRECIST were 1/ 14/ 74/ 9, 1/ 12/ 77/ 8, 34/ 34/ 25/ 5, 34/ 28/ 31/ 5, respectively. The κvalue of intermethod agreement for EASL vs WHO, EASL vs RECIST, mRECIST vs WHO, and mRECIST vs RECIST was 0.102, 0.088, 0.112 and 0.122, respectively. The κvalue for WHO vs RECIST and EASL vs mRECIST was 0.759 and 0.883 (p=0.00). Hazard ratios for TTP in responders compared with nonresponders were 0.313 (95% CI; 0.19-0.52, p=0.00) for EASL and 0.335 (95% CI; 0.21-0.54, p=0.00) for mRECIST. Hazard ratios for survival in responders compared with nonresponders were 0.208 (95% CI; 0.12-0.37, p=0.00) for EASL and 0.269 (95% CI; 0.15-0.48, p=0.00) for mRECIST. In the univariate analysis, tumor size, infiltrative type, PVT, EASL responder, and mRECIST responder were significant risk factors for survival. Multivariate analysis showed EASL responder (HR 0.165, 95% CI 0.056-0.486, p=0.001) and infiltrative type (HR 4.504, 95% CI 1.579-12.848, p=0.005) were independent predictable factors for survival.

Conclusions: The recent proposed methods showed different characteristics from preexisting methods in assessing treatment response and furthermore, responder by EASL method was independent predictor for survival in HCC patients receiving TACE. EASL method should be applied as response assessment method for HCC patients receiving TACE.

No significant financial relationships to disclose.