Today's Children, Tomorrow's America: Six Experts Face the Facts

Compiles essays about trends in family structure; how federal, state, and local budget deficits and projected cuts affect child poverty rates and health; and their long-term implications of reduced investment in children. Includes policy recommendations

The Attitudes, Level of Interest, and Knowledge Held by Physicians and Psychologists Toward Integrated Healthcare Practices and the Patient-Centered Medical Home Model

As the healthcare system evolves, issues related to cost and access to care continue to persist. In response to this concern, integrated models of healthcare, like the Patient-Centered Medical Home (PCMH), have been developed to work toward reducing cost for both patients and providers, increasing patient access to quality care, and improving patients’ overall satisfaction with the care that they are provided. However, despite the overwhelming evidence found in the literature supporting the efficacy and benefit of these treatment models, it is unclear as to why more providers do not choose to practice and support collaborative forms of healthcare provision. To understand how providers view and understand this approach to providing care, this study was developed to examine the current attitudes, levels of interest and knowledge that licensed practicing physicians and psychologists have toward integrated healthcare practices and the PCMH model. Participants completed an online questionnaire that was developed for this study to help illuminate a provider’s understanding and perceptions about integrated forms of care, based on three primary constructs: attitudes, interest, and knowledge. Findings suggested that psychologists held more positive attitudes, and a higher level of interest and knowledge about integrated models of healthcare than did physicians. The implications of the findings are discussed

Study protocol to investigate the effect of a lifestyle intervention on body weight, psychological health status and risk factors associated with disease recurrence in women recovering from breast cancer treatment

Background Breast cancer survivors often encounter physiological and psychological problems related to their diagnosis and treatment that can influence long-term prognosis. The aim of this research is to investigate the effects of a lifestyle intervention on body weight and psychological well-being in women recovering from breast cancer treatment, and to determine the relationship between changes in these variables and biomarkers associated with disease recurrence and survival. Methods/design Following ethical approval, a total of 100 patients will be randomly assigned to a lifestyle intervention (incorporating dietary energy restriction in conjunction with aerobic exercise training) or normal care control group. Patients randomised to the dietary and exercise intervention will be given individualised healthy eating dietary advice and written information and attend moderate intensity aerobic exercise sessions on three to five days per week for a period of 24 weeks. The aim of this strategy is to induce a steady weight loss of up to 0.5 Kg each week. In addition, the overall quality of the diet will be examined with a view to (i) reducing the dietary intake of fat to ~25% of the total calories, (ii) eating at least 5 portions of fruit and vegetables a day, (iii) increasing the intake of fibre and reducing refined carbohydrates, and (iv) taking moderate amounts of alcohol. Outcome measures will include body weight and body composition, psychological health status (stress and depression), cardiorespiratory fitness and quality of life. In addition, biomarkers associated with disease recurrence, including stress hormones, estrogen status, inflammatory markers and indices of innate and adaptive immune function will be monitored. Discussion This research will provide valuable information on the effectiveness of a practical, easily implemented lifestyle intervention for evoking positive effects on body weight and psychological well-being, two important factors that can influence long-term prognosis in breast cancer survivors. However, the added value of the study is that it will also evaluate the effects of the lifestyle intervention on a range of biomarkers associated with disease recurrence and survival. Considered together, the results should improve our understanding of the potential role that lifestyle-modifiable factors could play in saving or prolonging lives

ERK2 alone drives inflammatory pain but cooperates with ERK1 in sensory neuron survival

Extracellular signal-regulated kinases 1 and 2 (ERK1/2) are highly homologous yet distinct components of signal transduction pathways known to regulate cell survival and function. Recent evidence indicates an isoform-specific role for ERK2 in pain processing and peripheral sensitization. However, the function of ERK2 in primary sensory neurons has not been directly tested. To dissect the isoform-specific function of ERK2 in sensory neurons, we used mice with Cre-loxP-mediated deletion of ERK2 in Na(v)1.8(+) sensory neurons that are predominantly nociceptors. We find that ERK2, unlike ERK1, is required for peripheral sensitization and cold sensation. We also demonstrate that ERK2, but not ERK1, is required to preserve epidermal innervation in a subset of peptidergic neurons. Additionally, deletion of both ERK isoforms in Na(v)1.8(+) sensory neurons leads to neuron loss not observed with deletion of either isoform alone, demonstrating functional redundancy in the maintenance of sensory neuron survival. Thus, ERK1 and ERK2 exhibit both functionally distinct and redundant roles in sensory neurons. SIGNIFICANCE STATEMENT ERK1/2 signaling affects sensory neuron function and survival. However, it was not clear whether ERK isoform-specific roles exist in these processes postnatally. Previous work from our laboratory suggested either functional redundancy of ERK isoforms or a predominant role for ERK2 in pain; however, the tools to discriminate between these possibilities were not available at the time. In the present study, we use new genetic knock-out lines to demonstrate that ERK2 in sensory neurons is necessary for development of inflammatory pain and for postnatal maintenance of peptidergic epidermal innervation. Interestingly, postnatal loss of both ERK isoforms leads to a profound loss of sensory neurons. Therefore, ERK1 and ERK2 display both functionally distinct and redundant roles in sensory neurons

Psychometric Development of Scales Measuring Attitudes About and Interest in Integrated Healthcare Clinical Practice

The landscape of integrated healthcare models continues to evolve, and with these changes, providers are facing the challenge of adopting approaches to care that may not have been taught in their training. With interprofessional education on the rise, some providers often struggle to modify their clinical methodology to accommodate an interdisciplinary team-based care format. In an effort to better understand the attitudes and interest levels that may affect a provider’s engagement in these models of care, the Integrated Health Attitudes and Interest Scales were developed. Using a best practices model, items for the measure were created by the investigators and were independently reviewed by an expert panel of clinical psychologists. It was determined that both scales achieved content and construct validity as determined by a factor analysis. Prior to the time of the initial investigation, it is believed no other measure exists that assesses for these factors

Investigation into the High Voltage Shutdown of the Oxygen Generator System in the International Space Station

The Oxygen Generation System (OGS) Hydrogen Dome Assembly Orbital Replacement Unit (ORU) serial number 00001 suffered a cell stack high-voltage shutdown on July 5, 2010. The Hydrogen Dome Assembly ORU was removed and replaced with the on-board spare ORU serial number 00002 to maintain OGS operation. The Hydrogen Dome Assembly ORU was returned from ISS on STS-133/ULF-5 in March 2011 with test, teardown and evaluation (TT&E) and failure analysis to follow

RNA-Puzzles Round IV:3D structure predictions of four ribozymes and two aptamers

International audienceRNA-Puzzles is a collective endeavor dedicated to the advancement and improvement of RNA 3D structure prediction. With agreement from crystallographers, the RNA structures are predicted by various groups before the publication of the crystal structures. We now report the prediction of 3D structures for six RNA sequences: four nucleolytic ribozymes and two riboswitches. Systematic protocols for comparing models and crystal structures are described and analyzed. In these six puzzles, we discuss (i) the comparison between the automated web servers and human experts; (ii) the prediction of coaxial stacking; (iii) the prediction of structural details and ligand binding; (iv) the development of novel prediction methods; and (v) the potential improvements to be made. We show that correct prediction of coaxial stacking and tertiary contacts is essential for the prediction of RNA architecture, while ligand binding modes can only be predicted with low resolution and simultaneous prediction of RNA structure with accurate ligand binding still remains out of reach. All the predicted models are available for the future development of force field parameters and the improvement of comparison and assessment tools

Embedding physical activity in the heart of the NHS: the need for a whole-system approach

Solutions to the global challenge of physical inactivity have tended to focus on interventions at an individual level, when evidence shows that wider factors, including the social and physical environment, play a major part in influencing health-related behaviour. A multidisciplinary perspective is needed to rewrite the research agenda on physical activity if population-level public health benefits are to be demonstrated. This article explores the questions that this raises regarding the particular role that the UK National Health Service (NHS) plays in the system. The National Centre for Sport and Exercise Medicine in Sheffield is put forward as a case study to discuss some of the ways in which health systems can work in collaboration with other partners to develop environments and systems that promote active lives for patients and staff