Factors associated with young adult engagement with a web-based sickle cell reproductive health intervention

Objective

To determine the factors predicting the engagement of young adults who have sickle cell disease (SCD) or sickle cell trait (SCT) with an online reproductive health education intervention and engagement effects on knowledge.

Methods

The cross-sectional study included 167 participants who completed the web-based intervention either face-to-face (F2F) or online delivery (OL). Measures include: time used relative to length of the intervention narration and media (engagement) and the SCKnowIQ questionnaire. Ordinal regression was conducted.

Results

The sample mean age was 26-years (SD=5), 68% were female, 54% had SCD, and 68% were in the F2F group. Adjusting for age, partner sickle cell status, marital status, and education, participants who were female (p=.003), had SCD (p=.018), or had F2F delivery (p < .001) were more likely to spend more time on the intervention. Adjusting for baseline knowledge and modality, more time spent on the intervention was associated with higher posttest knowledge (p=.006).

Conclusions

Future studies are necessary to understand reasons underpinning engagement and to investigate other unmeasured factors, such as intervention interactivity elements, that could also be associated with engagement.

Innovation

This study of young adults with SCD or SCT provides much needed insight about their engagement with online reproductive health education.

Image processing tools for the validation of CryoEM maps

The number of maps deposited in public databases (Electron Microscopy Data Bank, EMDB) determined by cryo-electron microscopy has quickly grown in recent years. With this rapid growth, it is critical to guarantee their quality. So far, map validation has primarily focused on the agreement between maps and models. From the image processing perspective, the validation has been mostly restricted to using two half-maps and the measurement of their internal consistency. In this article, we suggest that map validation can be taken much further from the point of view of image processing if 2D classes, particles, angles, coordinates, defoci, and micrographs are also provided. We present a progressive validation scheme that qualifies a result validation status from 0 to 5 and offers three optional qualifiers (A, W, and O) that can be added. The simplest validation state is 0, while the most complete would be 5AWO. This scheme has been implemented in a website https://biocomp.cnb.csic.es/EMValidationService/ to which reconstructed maps and their ESI can be uploaded.

Development of a Minority Prostate Cancer Research Digest: Communication Strategy Statement for Black Men

Since prostate cancer incidence, prevalence and mortality are still highest among Black men in the United States, it is important to effectively address the factors that contribute to prostate cancer disparities in this at-risk population as well as their low participation in biomedical research/clinical trials. An effective communication strategy that can be used to disseminate information with high public health impact to Black men is one way to combat prostate cancer disparities. The objective of this study was to develop a Minority Prostate Cancer (MiCaP) research communication strategy using focus group methodology and expert in-depth interviews. The communication strategy statement developed in this study provides a guide for message concepts and materials for Black men, including communication content, source, channel, and location. Specifically, it provides recommendations on how to deliver information, how to choose the language and relevant images, how to gain attention, who is preferred to deliver messages, and other ways to engage Black men in health communication strategies. The communication strategy statement was used to develop the MiCaP Research Digest, a research communication program that is currently being tested in Orange County, Duval County, Leon County, Gadsden County, and the Tampa Bay area of Florida.

On bias, variance, overfitting, gold standard and consensus in single-particle analysis by cryo-electron microscopy

Single-particle analysis (SPA) by cryo-electron microscopy comprises the estimation of many parameters along its image-processing pipeline. Overfitting observed in SPA is normally due to misestimated parameters, and the only way to identify these is by comparing the estimates of multiple algorithms or, at least, multiple executions of the same algorithm.

Cryo-electron microscopy (cryoEM) has become a well established technique to elucidate the 3D structures of biological macromolecules. Projection images from thousands of macromolecules that are assumed to be structurally identical are combined into a single 3D map representing the Coulomb potential of the macromolecule under study. This article discusses possible caveats along the image-processing path and how to avoid them to obtain a reliable 3D structure. Some of these problems are very well known in the community. These may be referred to as sample-related (such as specimen denaturation at interfaces or non-uniform projection geometry leading to underrepresented projection directions). The rest are related to the algorithms used. While some have been discussed in depth in the literature, such as the use of an incorrect initial volume, others have received much less attention. However, they are fundamental in any data-analysis approach. Chiefly among them, instabilities in estimating many of the key parameters that are required for a correct 3D reconstruction that occur all along the processing workflow are referred to, which may significantly affect the reliability of the whole process. In the field, the term overfitting has been coined to refer to some particular kinds of artifacts. It is argued that overfitting is a statistical bias in key parameter-estimation steps in the 3D reconstruction process, including intrinsic algorithmic bias. It is also shown that common tools (Fourier shell correlation) and strategies (gold standard) that are normally used to detect or prevent overfitting do not fully protect against it. Alternatively, it is proposed that detecting the bias that leads to overfitting is much easier when addressed at the level of parameter estimation, rather than detecting it once the particle images have been combined into a 3D map. Comparing the results from multiple algorithms (or at least, independent executions of the same algorithm) can detect parameter bias. These multiple executions could then be averaged to give a lower variance estimate of the underlying parameters.

Genealogical relationships of mushroom bodies, hemiellipsoid bodies, and their afferent pathways in the brains of Pancrustacea: Recent progress and open questions

According to all latest phylogenetic analyses, the taxon Pancrustacea embraces the crustaceans in the traditional sense and the hexapods. Members of the Pancrustacea for a long time have been known to display distinct similarities in the architecture of their brains. Here, we review recent progress and open questions concerning structural and functional communalities of selected higher integrative neuropils in the lateral protocerebrum of pancrustaceans, the mushroom bodies and hemiellipsoid bodies. We also discuss the projection neuron pathway which provides a distinct input channel to both mushroom and hemiellipsoid bodies from the primary chemosensory centers in the deutocerebrum. Neuronal characters are mapped on a current pancrustacean phylogeny in order to extract those characters that are part of the pancrustacean ground pattern. Furthermore, we summarize recent insights into the evolutionary transformation of mushroom body morphology across the Pancrustacea.

Internet-based Tailored Virtual Human Health Intervention to Promote Colorectal Cancer Screening: Design Guidelines from Two User Studies

To influence user behaviors, Internet-based virtual humans (VH) have been used to deliver health interventions. However, Internet-based VH health interventions face challenges. The challenges can affect user perceptions of an Internet-based VH health intervention. In our work, we use an Internet-based VH health intervention to promote colorectal cancer (CRC) screening. We present design guidelines drawn from two studies. The two studies examined the influence of visual design and the influence of the information medium on user intentions to pursue more health information. In the first study, the analysis of the focus group (n=73 users) transcripts shows that the VH's visual realism, the VH's healthcare role, and the presence of a local healthcare provider's logo influenced user perceptions of the VH-based intervention's visual design. The findings from the focus groups were used to iterate the intervention and derive design guidelines. In the second study (n=1,400), the analysis of online surveys of users after the VH-based intervention showed that very few users focused on the VH's appearance. To influence the user intentions to pursue the health topic further, the results recommend the use of an animated VH to deliver health information compared to other mediums of information delivery, such as text. The design guidelines from the two studies can be used by developers to use VH-based interventions to influence users' intention to change behaviors.

Chemotherapy education: current practices of oncology nurses counseling patients

Purpose

Chemotherapy education provided by nurses to patients is a fundamental component of high-quality cancer care. The Quality Oncology Practice Initiative (QOPI ®) provides guidance on treatment-related aspects of chemotherapy education (diagnosis, goals, regimen, schedule, adverse events, follow-up), but recommendations on practical lifestyle issues lack evidence and standardization.

Methods

An anonymous, voluntary, uncompensated survey was distributed in October 2019 to 12,995 oncology certified nurses who report working in adult outpatient clinic/infusion room settings. An electronic survey was designed to determine current practice in nurse-patient counseling related to lifestyle and behavior during chemotherapy treatment.

Results

Survey responses were obtained from 1243 oncology certified nurses (9.6%). Nurses reported that their education practice was influenced by their institution and coworkers (other nurses or oncologists). Most nurses (> 50%) reported counseling on all topics asked. Most frequently counseled topics included water intake, infection monitoring, alcohol consumption, exercise, and mucositis. Less frequently counseled topics included hair dye, laundry practices, and mask wearing (pre-pandemic).

Conclusion

This study highlighted that chemotherapy nurses routinely counsel patients on important topics that lack evidence-based recommendations. In the absence of evidence, nurses rely on learned education practices, most commonly institutional guides or recommendations adopted from other nurses or oncologists. On important topics that lack evidence, expert panel review and development of consensus guidelines could standardize and improve the education process for both oncology nurses and patients.

Behavioral Weight Loss Intervention Preferences of Adolescents with Overweight/Obesity

Background: Behavioral lifestyle interventions are the foundation of adolescent obesity treatment. Tailoring an intervention using adolescent stakeholder engagement during the development process could improve intervention effectiveness. Methods: Adolescents with overweight/obesity ages 14-19 (n = 41) participated in 11 sex-specific focus groups (girls = 6, boys = 5) and were asked their preferences regarding who should lead the intervention and be involved, what the messaging of the program should be, how to make the program engaging and maintain participation, and how to best measure nutrition intake and activity. Transcripts were coded and analyzed for emergent themes. Results: Mean age was 16.0 ± 1.8 years and participants were racially/ethnically diverse. Adolescents preferred interventions that avoid a focus on "weight loss," and instead emphasize "healthy lifestyle," which represents a more comprehensive goal of targeting physical and mental well-being. Most participants indicated preferences for a relatable instructor with prior weight loss experience. Both sexes preferred optional parental involvement, as some parents were described as helpful, while others were perceived as a hindrance to success. Boys and girls identified incentives, engaging activities, and electronic communication as core components for engagement and retention, with girls emphasizing socialization and building relationships. Sex differences in preferences were observed. Girls had more concerns about intervention participation and preferred interventions to be sex stratified. Conclusions: Behavioral interventions to treat adolescent obesity should focus messaging/content on healthy lifestyles, rather than weight loss, and be sex stratified. Development and implementation of future behavioral interventions for adolescent obesity should consider tailoring to adolescent preferences when possible to improve feasibility, acceptability, and effectiveness.

Perspectives of pregnant and breastfeeding women on longitudinal clinical studies that require non-invasive biospecimen collection - a qualitative study

BACKGROUND

Investigation of the microbiome during early life has stimulated an increasing number of cohort studies in pregnant and breastfeeding women that require non-invasive biospecimen collection. The objective of this study was to explore pregnant and breastfeeding women's perspectives on longitudinal clinical studies that require non-invasive biospecimen collection and how they relate to study logistics and research participation.

METHODS

We completed in-depth semi-structured interviews with 40 women who were either pregnant (n = 20) or breastfeeding (n = 20) to identify their understanding of longitudinal clinical research, the motivations and barriers to their participation in such research, and their preferences for providing non-invasive biospecimen samples.

RESULTS

Perspectives on research participation were focused on breastfeeding and perinatal education. Participants cited direct benefits of research participation that included flexible childcare, lactation support, and incentives and compensation. Healthcare providers, physician offices, and social media were cited as credible sources and channels for recruitment. Participants viewed lengthy study visits and child protection as the primary barriers to research participation. The barriers to biospecimen collection were centered on stool sampling, inadequate instructions, and drop-off convenience.

CONCLUSION

Women in this study were interested in participating in clinical studies that require non-invasive biospecimen collection, and motivations to participate center on breastfeeding and the potential to make a scientific contribution that helps others. Effectively recruiting pregnant or breastfeeding participants for longitudinal microbiome studies requires protocols that account for participant interests and consideration for their time.

Understanding Perceptions and Attitudes in Breast Cancer Discussions on Twitter

Among American women, the rate of breast cancer is only second to lung cancer. An estimated 12.4% women will develop breast cancer over the course of their lifetime. The widespread use of social media across the socio-economic spectrum offers unparalleled ways to facilitate information sharing, in particular as it pertains to health. Social media is also used by many healthcare stakeholders, ranging from government agencies to healthcare industry, to disseminate health information and to engage patients. The purpose of this study is to investigate people's perceptions and attitudes related to breast cancer, especially those that are related to physical activities, on Twitter. To achieve this, we first identified and collected tweets related to breast cancer; and then used topic modeling and sentiment analysis techniques to understand discussion themes and quantify Twitter users' perceptions and emotions with respect tobreast cancer to answer 5 research questions.

Recruitment and Retention of Pregnant and Breastfeeding Mothers for Longitudinal Clinical Microbiome Studies (OR30-08-19)

Objectives

Accumulating data suggest the health benefits of breastfeeding are, in part, mediated through interactions with the human microbiome. Despite these observations, recruitment of pregnant mothers in longitudinal clinical microbiome studies remains a significant challenge. The goal of this study is to develop data-driven strategies for recruitment and retention of breastfeeding mothers’ into longitudinal clinical microbiome studies.

Methods

We recruited a total of 40 mothers (20 pregnant and 20 breastfeeding) to complete in-depth semi-structured interviews at the UF Clinical and Translational Science Institute. Additionally, mothers were asked to use self-administered microbiome collection kits and complete questionnaires related to health history, infant feeding practices, and physical activity. Informative interviews were designed to identify women's understanding, motivations and barriers surrounding longitudinal clinical research participation and their preferences for providing non-invasive biological samples.

Results

Our preliminary analysis indicates that 1) barriersfor participating in research include convenience, confidentiality and child protection; 2) factors motivating participation in research include general interest in breastfeeding, schedule, and perceived research relevance; 3) participant recruitment should consider social media and 4) biological sample collection should include adequate instructions and drop-off convenience.

Conclusions

The results of this study provide valuable theoretical and practical insights on how to effectively recruit and retain pregnant and breastfeeding women into longitudinal microbiome studies.

Funding Sources

1K01DK115632-01A1.

Creating an mHealth App for Colorectal Cancer Screening: User-Centered Design Approach

Background

Patients are increasingly using mobile health (mHealth) apps to monitor their health and educate themselves about medical issues. Despite the increasing popularity of such apps, poor design and usability often lead to suboptimal continued use of these apps and subsequently to poor adherence to the behavior changes at which they are aimed. One solution to these design problems is for app developers to use user-centered design (UCD) principles to consider the context and needs of users during the development process.

Objective

This study aimed to present a case study on the design and development process for an mHealth app that uses virtual human technology (VHT) to encourage colorectal cancer (CRC) screening among patients aged 50 years and above.

Methods

We have first provided an overview of the project and discussed its utilization of VHT. We have then reviewed UCD principles and how they can be incorporated into the development of health apps. We have described how we used UCD processes during the app’s development. We have then discussed the unique roles played by communication researchers, computer scientists, clinicians, and community participants in creating an mHealth app that is credible, usable, effective, and accessible to its target audience.

Results

The principles of UCD were woven throughout the project development, with researchers collecting feedback from patients and providers at all stages and using that feedback to improve the credibility, usability, effectiveness, and accessibility of the mHealth app. The app was designed in an iterative process, which encouraged feedback and improvement of the app and allowed teams from different fields to revisit topics and troubleshoot problems.

Conclusions

Implementing a UCD process contributed to the development of an app, which not only reflected cross-disciplinary expertise but also the needs, wants, and concerns of patients.

Expression of odorant-binding proteins in mouthpart palps of the desert locust Schistocerca gregaria

Odorant-binding proteins (OBPs) are essential molecular elements of the insect chemosensory system, which is composed of the antennae and the mouthpart palps (maxillary and labial). In this study, we have analysed the expression and the sensilla specificity of 14 OBP subtypes in the palps of the desert locust Schistocerca gregaria. The locust palps comprise only a low number of sensilla basiconica but a high number of sensilla chaetica. Employing a variety of approaches, we found that only a subset of the antennal OBP repertoire was expressed in both palp types. These OBPs were previously shown to be expressed either in sensilla basiconica or sensilla chaetica of the antennae. Comparing the expression pattern in the two chemosensory organs revealed similarities and differences; most remarkably, two OBP subtypes, OBP6 and OBP8, were found in both sensilla types on palps, whereas on the antennae they were solely expressed in one sensillum type. Together, the data indicate a differential, but partly overlapping, expression of OBPs in the two sensilla types of the palps. The differences in the expression pattern of OBP subtypes between antennae and palps might be indicative for distinct functions of the OBPs in the two chemosensory organs.

Survey of the analysis of continuous conformational variability of biological macromolecules by electron microscopy

Single-particle analysis by electron microscopy is a well established technique for analyzing the three-dimensional structures of biological macromolecules. Besides its ability to produce high-resolution structures, it also provides insights into the dynamic behavior of the structures by elucidating their conformational variability. Here, the different image-processing methods currently available to study continuous conformational changes are reviewed.

Abstract C04: Impact of a Minority Prostate Cancer (MiCaP) Research Digest in translating scientific discovery into public health and community applications

Background and Objective: Although prostate cancer (CaP) mortality and morbidity have declined since the 1990s, Black men (BM) are still disproportionately affected by CaP. It will take a concerted and inventive effort to address the burden of CaP in BM. A unique approach that is of significant interest to our team is increased access to life-changing, scientific CaP discoveries for BM, especially those with implications for primary and secondary preventive interventions. The primary objective of this study was to develop a research dissemination program, the Minority Prostate Cancer (MiCaP) Research Digest, which will spread information about CaP scientific discoveries, evidence-based interventions, and open clinical trials instantly among BM. We hypothesized that knowledge, attitude, perceived behavioral control, cues to action, and risk-reduction and prevention behaviors will be higher among the users of the MiCaP Research Digest compared to nonusers.

Methodology: The development of the MiCaP Research Digest was guided by valid behavioral and health communication models and based on an understanding of the scientific information needs of BM. The targeted population was BM between the ages of 35 and 70 years. The research setting was in Florida. We employed focus groups and individual interviews to plan and select the strategy, channel, and material for the digest. Subsequently, the communication strategy statement was used to develop message concepts and materials. A cross-sectional pre- post study design was employed to establish the efficacy of the Digest among 33 BM.

Results: The Digest comprised a one-page public abstract and a 7-minute video that includes: (1) Digest Minute sound bite by the author; (2) 4-minute discussion with the author taking questions from a CaP advocate and a peer scientist; (3) Digest Minute recap by the scientist and advocate; and (4) a clinical trial opportunity session. The first volume focused on “Prostate tumor gene expression in Black men.” Majority of the 33 participants who previewed the Digest were native-born BM, between 60 and 69 years, had college degrees, were married, and had full-time employment. Based on McNemar's test results of pre- and post-assessments, there was significant improvement in the knowledge and self-efficacy of participants. In rating the Digest, 100% of participants were satisfied with it, 96% rated the digest information as satisfactory, 87% rated it as better than expected, and 97% rated the quality as high. Participants' written feedback was also very positive.

Conclusion: Although many biomedical research projects are funded through public dollars, oftentimes the scientific discoveries from the projects are inaccessible for the public. This is especially disconcerting when such discoveries can have immediate impact on a disease that disproportionately affects a specific population, Black men (BM). The MiCaP Research Digest provides a vehicle for BM to access high-impact CaP scientific discoveries, thereby facilitating the immediate translation of scientific discoveries into public health applications.

Citation Format: Folakemi Odedina, Kim Walsh-Childers, Mary Ellen Young, Getachew Dagne, Janice Krieger, Ernest Kaninjing, Nissa Askins. Impact of a Minority Prostate Cancer (MiCaP) Research Digest in translating scientific discovery into public health and community applications [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C04.

A Research Agenda for Communication Scholars in the Precision Medicine Era

The 2015 announcement of the Precision Medicine Initiative (PMI) galvanized and energized efforts to reconsider medical practice through tailoring of prevention and treatment recommendations based on genetics, environment, and lifestyle. Numerous disciplines contributed white papers identifying challenges associated with PMI and calling for discipline-specific research that might provide solutions to such challenges. Throughout these white papers, the prominence of communication in achieving the PMI's goals is obviously apparent. In this article, we highlight opportunities for communication scholars' contributions to the PMI based on challenges identified in white papers from other disciplines and work already conducted by research teams in the field of communication.

Male depression – actual a male specific disorder or potentially a new subtype of depression?

Introduction

Although depression is one of the most prevalent disorders around the world we know only little about the effect of factors like gender-related norms or personality-related aspects in the expression of depressive symptoms. Current findings of studies are heterogeneous and lead to the conclusion that depression is more prevalent in women as well as that they have a higher risk for depression. Women express more typical depressive symptoms while men offer more atypical symptoms like aggressiveness, irritability, alcohol misuse which is constituted as male depression (MD).

Objective

Male and female patients with a diagnosis of depressive episode or recurrent depressive disorder (ICD-10) who are treated in in-patient or day clinic setting of two psychiatric institutions in Lower Saxony and one psychiatric university hospital in Austria. Study period: November 2016 to November 2017. No limitations to further diagnosis, age or other factors.

Methods

To analyze the expression of (a) typical depressive symptoms as well as causes of and factors of influence in diverse types of depression different questionnaires and quantitative methods will be used.

Aims

Investigate gender-specific differences in the expression of symptoms in male and female patients with a depressive disorder. Focus: whether symptoms of MD are more prevalent for depressive men than women. Furthermore, causes and factors of (a)typical depressive symptoms should be analyzed.

Results

First results will be presented.

Conclusion

The results of the study should lead to the conclusion whether there exist any gender-specific differences in the expression of depressive symptoms and what they might be caused by.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Larval sensilla of the moth Heliothis virescens respond to sex pheromone components

Female-released sex pheromones orchestrate the mating behaviour of moths. Recent studies have shown that sex pheromones not only attract adult males but also caterpillars. Single sensillum recordings revealed that larval antennal sensilla of the moth Heliothis virescens respond to specific sex pheromone components. In search for the molecular basis of pheromone detection in larvae, we found that olfactory sensilla on the larval antennae are equipped with the same molecular elements that mediate sex pheromone detection in adult male moths, including the Heliothis virescens receptors 6 (HR6) and HR13, as well as sensory neurone membrane protein 1 (SNMP1). Thirty-eight olfactory sensory neurones were identified in three large sensilla basiconica; six of these are considered as candidate pheromone responsive cells based on the expression of SNMP1. The pheromone receptor HR6 was found to be expressed in two cells and the receptor HR13 in three cells. These putative pheromone responsive neurones were accompanied by cells expressing pheromone-binding protein 1 (PBP1) and PBP2. The results indicate that the responsiveness of larval sensilla to female-emitted sex pheromones is based on the same molecular machinery as in the antennae of adult males.

The sensory neurone membrane protein SNMP1 contributes to the sensitivity of a pheromone detection system

Male moths detect female-released sex pheromones with extraordinary sensitivity. The remarkable sensory ability is based on a cooperative interplay of pheromone binding proteins in the lymph of hair-like sensilla trichodea and pheromone receptors in the dendrites of sensory neurones. Here we examined whether in Heliothis virescens the so-called 'sensory neurone membrane protein 1' (SNMP1) may contribute to responsiveness to the pheromone component, (Z)-11-hexadecenal (Z11-16:Ald). By means of immunohistochemistry and in situ hybridization we demonstrated that SNMP1 is in fact present in cells expressing the Z11-16:Ald receptor HR13 and the dendrites of sensory neurones. To assess a possible function of SNMP1 we monitored the responsiveness of cell lines that expressed HR13 alone or the combination SNMP1/HR13 to stimulation with Z11-16:Ald by calcium imaging. It was found that SNMP1/HR13 cells were 1000-fold more sensitive to pheromone stimulation compared with HR13 cells. In contrast, cells that expressed HR13 and the non-neuronal SNMP2-type showed no change in pheromone sensitivity. Overall, our reconstitution experiments demonstrate that the presence of SNMP1 significantly increases the HR13-based responsiveness of cells to Z11-16:Ald, suggesting that SNMP1 also contributes to the response of the antennal neurones and thus to the remarkable sensitivity of the pheromone detection system.

ESR Study on Complexes Formed on Reaction of cis-Dichlorodiammineplatinum(II) with Cytosine and Cytidine

The ESR spectra of novel paramagnetic comple-xes between cis-dichlorodiammineplatinum(II) and cytosine or cytidine in aqueous solution are presented and discussed. The results imply a complex containing a binuclear metal-metal bonded platinum moiety with an unpaired electron spin delocalized over the dz2-orbitals.

How prevention curricula are taught under real-world conditions: Types of and reasons for teacher curriculum adaptations

PURPOSE

As interventions are disseminated widely, issues of fidelity and adaptation become increasingly critical to understand. This study aims to describe the types of adaptations made by teachers delivering a school-based substance use prevention curriculum and their reasons for adapting program content.

DESIGN/METHODOLOGY/APPROACH

To determine the degree to which implementers adhere to a prevention curriculum, naturally adapt the curriculum, and the reasons implementers give for making adaptations, the study examined lesson adaptations made by the 31 teachers who implemented the keepin' it REAL drug prevention curriculum in 7th grade classrooms (n = 25 schools). Data were collected from teacher self-reports after each lesson and observer coding of videotaped lessons. From the total sample, 276 lesson videos were randomly selected for observational analysis.

FINDINGS

Teachers self-reported adapting more than 68 percent of prevention lessons, while independent observers reported more than 97 percent of the observed lessons were adapted in some way. Types of adaptations included: altering the delivery of the lesson by revising the delivery timetable or delivery context; changing content of the lesson by removing, partially covering, revising, or adding content; and altering the designated format of the lesson (such as assigning small group activities to students as individual work). Reasons for adaptation included responding to constraints (time, institutional, personal, and technical), and responding to student needs (students' abilities to process curriculum content, to enhance student engagement with material).

RESEARCH LIMITATIONS/IMPLICATIONS

The study sample was limited to rural schools in the US mid-Atlantic; however, the results suggest that if programs are to be effectively implemented, program developers need a better understanding of the types of adaptations and reasons implementers provide for adapting curricula.

PRACTICAL IMPLICATIONS

These descriptive data suggest that prevention curricula be developed in shorter teaching modules, developers reconsider the usefulness of homework, and implementer training and ongoing support might benefit from more attention to different implementation styles.

ORIGINALITY/VALUE

With nearly half of US public schools implementing some form of evidence-based substance use prevention program, issues of implementation fidelity and adaptation have become paramount in the field of prevention. The findings from this study reveal the complexity of the types of adaptations teachers make naturally in the classroom to evidence-based curricula and provide reasons for these adaptations. This information should prove useful for prevention researchers, program developers, and health educators alike.

The Rural Context of Illicit Substance Offers: A Study of Appalachian Rural Adolescents

Rural adolescents are at risk for early initiation and problematic substance use, but to date few studies have examined the rural context of substance use. To better understand substance offers in the rural context, semi-structured interviews were conducted with 118, 12-19 year old adolescents (M = 13.68, SD = 1.37) from Appalachian, rural school districts in Pennsylvania and Ohio. Interviews elicited stories about substance offer-response episodes including where offers occurred, who offered substances, and how youth gained access to illicit substances. Findings describe the settings in which substance offers and use occur for these rural adolescents and advance prevention efforts for tailoring health messages to this target population.

Effect of continuous positive airway pressure treatment on the subsequent EEG spectral power and sleepiness over sustained wakefulness in patients with obstructive sleep apnea-hypopnea syndrome

OBJECTIVE

To determine whether sleepiness and its evolution over sustained wakefulness could be reversed by nasal continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).

METHODS

Twelve OSAHS patients underwent three 32-h sessions of study: one before CPAP therapy (T0), the second (T3) and the third (T6), respectively, after 3 and 6 months of therapy. Each session included one night of sleep followed by 24 h of sustained wakefulness, during which EEG recordings and subjective ratings were performed every hour.

RESULTS

The waking EEG in treated OSAHS patients was partially improved after 3 months of CPAP and their subjective complaint of sleepiness was normalized after 6 months. Theta power (3.9-7.8 Hz) was decreased as well as its time course during the diurnal period but beta power (12.7-29.2 Hz) remained higher.

CONCLUSIONS

CPAP partially reverses waking EEG abnormalities in OSAHS patients with reduced theta activity after 3 months and removes the subjective complaint of sleepiness after 6 months. Nevertheless, the persistence of increased beta activity in treated patients suggests that efforts to stay awake remain strong after CPAP treatment.

SIGNIFICANCE

CPAP influences the EEG's time course over sustained wakefulness in a frequency-specific manner in OSAHS patients.

Transition from marine to terrestrial ecologies: changes in olfactory and tritocerebral neuropils in land-living isopods

In addition to the ancestors of insects, representatives of five lineages of crustaceans have colonized land. Whereas insects have evolved sensilla that are specialized to allow the detection of airborne odors and have evolved olfactory sensory neurons that recognize specific airborne ligands, there is so far little evidence for aerial olfaction in terrestrial crustaceans. Here we ask the question whether terrestrial Isopoda have evolved the neuronal substrate for the problem of detecting far-field airborne chemicals. We show that conquest of land of Isopoda has been accompanied by a radical diminution of their first antennae and a concomitant loss of their deutocerebral olfactory lobes and olfactory computational networks. In terrestrial isopods, but not their marine cousins, tritocerebral neuropils serving the second antenna have evolved radical modifications. These include a complete loss of the malacostracan pattern of somatotopic representation, the evolution in some species of amorphous lobes and in others lobes equipped with microglomeruli, and yet in others the evolution of partitioned neuropils that suggest modality-specific segregation of second antenna inputs. Evidence suggests that Isopoda have evolved, and are in the process of evolving, several novel solutions to chemical perception on land and in air.

25-Hydroxyvitamin D in Canadian adults: biological, environmental, and behavioral correlates

SUMMARY

We assessed vitamin D status and its correlates in the population-based Canadian Multicentre Osteoporosis Study (CaMos). Results showed that serum 25-hydroxyvitamin D levels <75 nmol/L were common. Given Canada's high latitude, attention should be given to strategies for enhancing vitamin D status in the population.

INTRODUCTION

Inadequate vitamin D has been implicated as a risk factor for several clinical disorders. We assessed, in a Canadian cohort, vitamin D status and its correlates, based on serum 25-hydroxyvitamin D [25(OH)D], the best functional indicator of vitamin D status.

METHODS

We studied 577 men and 1,335 women 35+ years from seven cities across Canada in the randomly selected, population-based Canadian Multicentre Osteoporosis Study (CaMos). Participants completed a comprehensive questionnaire. Serum 25(OH)D was measured by immunoassay. Multivariate linear regression modeling assessed the association between 25(OH)D and determinants of vitamin D status.

RESULTS

Participants (2.3%) were deficient in 25(OH)D (<27.5 nmol/L); a further 18.1% exhibited 25(OH)D insufficiency (27.5-50 nmol/L). Levels <75 nmol/L were evident in 57.5% of men and 60.7% of women and rose to 73.5% in spring (men) and 77.5% in winter (women); 25(OH)D <50 nmol/L was ≤10% year round for those supplementing with ≥400 IU vitamin D/day but was 43.9% among those not supplementing in winter and spring. The strongest predictors of reduced 25(OH)D for both men and women were winter and spring season, BMI ≥30, non-white ethnicity, and lower vitamin D supplementation and its modification by fall and winter.

CONCLUSIONS

In this national Canadian cohort, vitamin D levels <75 nmol/L were common, particularly among non-white and obese individuals, and in winter and spring. Vitamin D intake through diet and supplementation and maintenance of normal weight are key modifiable factors for enhancing vitamin D status and thus potentially influencing susceptibility to common chronic diseases.

Alcohol and Other Drug Resistance Strategies Employed by Rural Adolescents

This study seeks to identify how rural adolescents make health decisions and utilize communication strategies to resist influence attempts in offers of alcohol, tobacco, and other drugs (ATOD). Semi-structured interviews were conducted with 113 adolescents from rural school districts to solicit information on ATOD norms, past ATOD experiences, and substance offer-response episodes. Rural youths' resistance strategies were similar to previous findings with urban adolescents - refuse, explain, avoid, and leave (the REAL typology) - while unique features of these strategies were identified including the importance of personal narratives, the articulation of a non-user identity, and being "accountable" to self and others.

Medico-legal implications of sleep apnoea syndrome: Driving license regulations in Europe

BACKGROUND

Sleep apnoea syndrome (SAS), one of the main medical causes of excessive daytime sleepiness, has been shown to be a risk factor for traffic accidents. Treating SAS results in a normalized rate of traffic accidents. As part of the COST Action B-26, we looked at driving license regulations, and especially at its medical aspects in the European region.

METHODS

We obtained data from Transport Authorities in 25 countries (Austria, AT; Belgium, BE; Czech Republic, CZ; Denmark, DK; Estonia, EE; Finland, FI; France, FR; Germany, DE; Greece, GR; Hungary, HU; Ireland, IE; Italy, IT; Lithuania, LT; Luxembourg, LU; Malta, MT; Netherlands, NL; Norway, EC; Poland, PL; Portugal, PT; Slovakia, SK; Slovenia, SI; Spain, ES; Sweden, SE; Switzerland, CH; United Kingdom, UK).

RESULTS

Driving license regulations date from 1997 onwards. Excessive daytime sleepiness is mentioned in nine, whereas sleep apnoea syndrome is mentioned in 10 countries. A patient with untreated sleep apnoea is always considered unfit to drive. To recover the driving capacity, seven countries rely on a physician's medical certificate based on symptom control and compliance with therapy, whereas in two countries it is up to the patient to decide (on his doctor's advice) to drive again. Only FR requires a normalized electroencephalography (EEG)-based Maintenance of Wakefulness Test for professional drivers. Rare conditions (e.g., narcolepsy) are considered a driving safety risk more frequently than sleep apnoea syndrome.

CONCLUSION

Despite the available scientific evidence, most countries in Europe do not include sleep apnoea syndrome or excessive daytime sleepiness among the specific medical conditions to be considered when judging whether or not a person is fit to drive. A unified European Directive seems desirable.

[18F] FDG-PET/CT as a new and sensitive imaging method for the diagnosis of large vessel vasculitis

OBJECTIVE

To determine the value of the new imaging modality positron-emission tomography/computed tomography (PET/CT) for the diagnosis and re-evaluation of large vessel vasculitis.

METHODS

Thirteen patients newly diagnosed or re-evaluated for suspected clinical disease activity of Takayasu arteritis (TA, 3 patients) or giant cell arteritis (GCA, 10 patients) underwent PET/CT. Clinical activity status, serological markers, and alternative imaging methods were evaluated.

RESULTS

In patients with clinical activity despite nearly normal erythrocyte sedimentation rate (ESR) and C reactive protein (CRP), disease activity could be shown by PET-CT. A long segmental, increased fluoro-deoxyglucose (FDG) uptake in the vessel wall served as confirmation of the vascular inflammation. The aortic arch was involved in all patients with active disease (n=12). In the complementary CT scans, stenotic lesions were found in 8 out of 13 patients. Duplex ultrasonography was performed in 11/13 patients and was positive in nine of these patients at least at one site. Magnetic resonance imaging (MRI) was done for confirmation in 10 patients.

CONCLUSION

Doppler ultrasonography is a very useful and widely available method to confirm a first suspicion of vasculitis, but it has limitations especially at the large thoracic vessels, which are affected in many cases. ESR and CRP alone are not sufficient to evaluate disease activity. The new imaging modality PET/CT provides the additional information. It allows the evaluation of disease activity and vessel morphology as well as the localization of the inflammatory process in the same session.

The expression pattern of four odorant-binding proteins in male and female silk moths, Bombyx mori

Four recombinant odorant-binding proteins of Bombyx mori, pheromone-binding protein (PBP), general odorant-binding protein 1 (GOBP1), general odorant-binding protein 2 (GOBP2) and antennal binding protein X (ABPX), were expressed in E. coli and used to raise polyclonal antisera. Immunoblots of antennal homogenates showed that these antisera were specific. In Western blot analysis and immunocytochemical labelling experiments, the sera against recombinant PBP and GOBP2 of B. mori gave identical results as sera against native PBP and GOBP2 of Antheraea polyphemus, respectively, thus confirming earlier results obtained with the latter. Labelling consecutive cross sections of various sensillum types with all four antisera revealed different labelling patterns in male and female sensilla (s.) trichodea and s. basiconica. Long s. trichodea in males and females represented uniform labelling types, whereas for short s. trichodea, s. intermedia, and s. basiconica a great variety of labelling patterns was observed, some being more common than others. Long s. trichodea, which in males are uniformly tuned to the pheromone components bombykol and bombykal, all strongly expressed PBP; labelling with antisera against the other three odorant-binding proteins hardly was above background, only in some hairs GOBP1 was expressed somewhat more strongly. Long s. trichodea of females, which respond specifically to linalool and benzoic acid, showed a different labelling pattern. Here, we observed strong labelling with antibodies against GOBP2 and medium labelling with anti-GOBP1, sometimes with anti-ABPX. S. basiconica in both sexes most commonly co-expressed GOBP1 and GOBP2, but other patterns were occasionally found, with some of them showing PBP expression, also in females. The great variety of labelling types in short s. trichodea, s. intermedia, and s. basiconica suggests a similar variety of functional subtypes as observed in plant odour-sensitive sensilla of other moth species.

REM sleep behavior disorder: clinical and physiopathological findings

Abnormalities of REM sleep i.e. absence of atonia and abnormal motor control which are described in patients with REM sleep behavior disorder, have induced clinical and physiopathological interest. Initial hypothesis of a simple dysfunction of REM sleep generators has not been confirmed. The prevalence in older subjects and in patients with parkinsonian syndromes suggest that the appearance of the parasomnia is related to alteration in the neurons of pontine area i.e. nucleus peduncolopontine, in which there is an integration of sleep-wake mechanisms and locomotor systems. Controversy surrounds the specificity of absence of atonia in the diagnosis of the parasomnia. Since this polygraphic finding may be present in subjects without any sleep complaint and in patients with initial neurological impairment, diagnosis of the sleep disorders might be allowed only when the polygraphic characteristic of persistent tonus and complex motor behavior are recorded.