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Hepatic Injury
Get PDFThis document summarizes the rationale, equipment, measurement, protocol and data cleaning procedures for each of the hepatic measures collected at the Wave VI home exam. It also documents how constructed variables were derived from the hepatic measures collected in the field. Whenever possible, data collection and methods in Wave VI mirrored those of Wave V to ensure comparability of data between waves, although important inter-Wave differences between Waves IV-VI exist and are grey-highlighted herein. This document is one in a set of Wave VI user guides.
Altitudes adaptation and development: Content analysis of experiences and preferences for a digital intervention to support early psychosis caregivers in the United States
Get PDFPurpose Family involvement in Coordinated Specialty Care (CSC) can enhance engagement and improve outcomes for young people with First Episode Psychosis (FEP). Digital interventions can circumvent many of the access and resource barriers that prevent families from engaging. The purpose of the current study was to better understand the experiences and challenges faced by caregivers who support a young person with FEP in the United States, and to use this information to guide the adaptation and further development of a digital intervention to support caregiver health and well-being. Methods Participants engaged in interviews and focus groups centered on their experiences supporting an adult child with FEP, connecting their relative to CSC, and their preferences for a digital intervention to support caregivers. This study used content analysis to develop themes and subthemes across interview and focus group data. Results Eight participants participated in the interviews and focus groups. Our findings support prior research indicating caregivers of young people with psychosis need evidence-based information about psychosis and assistance in managing systemic, social, and intrapersonal challenges. Participants advocated for a program with multimedia that could be accessed anywhere and anytime, facilitated connections with other caregivers, and emphasized messages of hope and recovery. Conclusion Interventions aiming to promote mental health and well-being for FEP caregivers in the United States should incorporate evidence-based information about psychosis specific to caregivers and their relative's recovery stage, guidance for navigating the healthcare system and privacy laws, and actionable skills related to illness management, effective communication, and self-care
Unpacking the Primary Care Clinician Index: Understanding How Changes in Population and Workforce Supply Affect Access to Primary Care in North Carolina
Get PDFConcerns about primary care access in North Carolina are intensifying. The Primary Care Clinician (PCC) Index analyzes the ratio of PCCs to the North Carolina population across the state’s 100 counties. Between 2017 and 2024, the number of counties not meeting the 1500 people to 1 PCC ratio decreased from 36 to 20
The Only Constant is Change: Emerging Adulterants in the Unregulated Drug Supply
No full textPresentation for the IPRC Connect, Empower, Prevent webinar series, delivered on 11/19/202
Intersectional stigma and resilience in the uptake of cervical cancer prevention services in Nigeria: a qualitative study.
Get PDFCervical cancer is one of the leading causes of death among women in Africa, but stigma often delays cervical cancer prevention. We explore the perceptions, enablers and nurturers through the lens of intersectional stigma in the uptake of cervical cancer prevention services in Nigeria.Indepth interviews and focus group discussions were conducted among women aged 30-65 years and girls aged 9-26 years in Lagos, Nigeria. Data were analysed thematically. Using the relationships and expectation domain of the PEN-3 cultural model, we identified perceptions, enablers and nurturers related to the uptake of primary and secondary cervical cancer prevention services in Nigeria. We also explored how social identities may intersect with health-related stigmas and affect the uptake of these services.We interviewed 31 women and 31 girls. 61% of the participants were Christians and 39% were Muslims and were from the three major ethnic groups in Nigeria: Igbo (34%), Hausa (38%) and Yoruba (28%). Themes emerging from the data: (1) positive perceptions (self-efficacy): many women understood the importance of protecting themselves and their daughters from cervical cancer and strongly believed that they could educate their partners/husbands and would not let other people's experiences with the vaccine influence them negatively. (2) Negative perceptions (anticipated stigma): some women expressed that because the human papillomavirus that causes cervical cancer is mainly sexually transmitted, they were concerned that they may be perceived as being promiscuous if they decide to commence routine cervical cancer screening. (3) Enablers (social support): nearly all women wanted the support of their spouses before receiving cervical cancer screening. (4) Nurturers (resilience): many clearly understood the complex social and economic realities faced by Nigerians that negatively affect their access to healthcare.These findings offer intersectional insights into advancing public health and culturally anchored interventions to preventing cervical cancer-related stigma in Nigeria
Feasibility and usability of a voice-based dietary recall tool in older adults: A pilot comparison with ASA-24.
Get PDFDietary assessment is important for identifying patterns that can influence an older adult's medical conditions. Existing assessments are dependent on the recall limit of the current use of dietary tools. This pilot study aimed to compare the short-term usability and acceptability of a novel voice-based dietary recall tool (DataBoard) to the traditional Automated Self-Administered Dietary Assessment Tool (ASA-24) in older adults. Participants aged over 65 years old, meeting specific criteria, were recruited through Research For Me and Research Match across a six-month period in 2023-2024. During the session on Zoom, they were randomly assigned to complete either a voice-based recall via DataBoard or use ASA-24 first, followed by a semi-structured interview. DataBoard enables survey completion using speech input through shared links. We obtained data on meal choices, participant feedback, and preferences for either method using a 1-10 rating scale (low to high agreement). Descriptive statistics and qualitative coding were conducted.We recruited 20 participants (mean age 70.5 ± 4.26 years, 55% female and 35% non-White). Feasibility and acceptability of DataBoard's voice-based recall were rated as 7.95/10 and 7.6/10. Participants rated the overall performance of DataBoard as easier than the ASA-24, with an average rating of 6.7/10. Participants preferred using DataBoard; they felt it could be used more frequently to report food than ASA-24 (mean 7.2/10). Dedoose analysis revealed preferences, challenges, and usability insights for DataBoard. Older adults supported voice-based recall as a means to evaluate dietary intake. Further evaluation with larger cohorts of older adults could provide additional opportunities to create a better tool for food recall
Condensates act as translation hubs to coordinate multinucleate cell growth.
No full textCoordination between growth and division is a fundamental feature of cells. In many syncytia, cell growth must couple with multiple nuclear divisions in one cytoplasm. In the fungus, Ashbya gossypii, cell-cycle progression and hyphal elongation require condensates formed by the protein Whi3 in complex with distinct mRNA species. We hypothesized the condensates may act through local translation regulation and find that Whi3 target mRNAs show distinct spatial biases in translation in vivo. Whi3-RNA condensates can both promote and repress RNA translation in an RNA- and condensate size-dependent manner in vitro. Interestingly, we observe a sub-condensate enrichment of translation that is tunable by RNA valency and protein phospho-state. Together, these data suggest that Whi3 condensates generate a continuum of translation states, resulting in asynchronous nuclear divisions coordinated with growth. This local regulation requires a minimal complement of molecular components at the nano scale to support global coordination at the cell scale
Professional nurse advocates and restorative clinical supervision: national survey of programme implementation and impact
Get PDFBackground In 2021, a new national Programme of clinical nurse leadership, called the Professional Nurse Advocate Programme, was launched across the National Health Service of England. The primary aim was to support nurse wellbeing and resilience in the aftermath of Covid-19 pandemic. Trained nurse advocates offered restorative clinical supervision sessions to nurses, career conversations through the Advocating and Educating for Quality Improvement model, aiming to sustain their motivation at work through improved wellbeing. This paper evaluates the national Programme delivered across England. Methods Cross-sectional questionnaire, underpinned by Laschinger’s model of empowerment, distributed across England in 2022. This explored the effectiveness and impact of Restorative Clinical Supervision on nurse empowerment, and personal effectiveness. The questionnaire sections included demographics and 14 questions to understand restorative clinical supervision in practice; respondents’ abilities to fulfil PNA roles and responsibilities; and four open text questions. Demographic data were analysed using descriptive statistics. Open text responses were coded to generate themes. Results There were 302 questionnaire responses from nurses receiving restorative clinical supervision n = 73, Professional Nurse Advocates n = 214 and leads n = 15, most were female and identified as ‘white’ ethnicity. Restorative clinical supervision was rated very positively, enhancing structural and psychological empowerment. Three primary themes were identified from open-ended questions; (i) Conditions necessary for restorative supervision; (ii) Nurse engagement and organisational commitment to restorative supervision and (iii) Reinvigoration from supervision. Conclusion We established that the professional clinical leadership role of the nurse advocates offers individual support through reflective practice and strategies to address resilience. Spaces of safety and adequate time are reported as fundamental to delivering the advocate role, plus time for nurses to be released from clinical duties to participate in restorative supervision. Since the roll out of the Programme 10,933 training places have been funded, representing significant investment. 78,187 restorative clinical supervision sessions; 49,595 career conversations and 2,541 Quality Improvement projects were underway in October 2024. This is the first national evaluation of the Programme and findings indicate its potential to address underlying global nursing concerns linked to workforce attrition, wellbeing in the workplace, retention, and recognition of nurse impact. Public or Patient Contribution Not applicable. Clinical trial number Not applicable
Dishevelled-1 regulates global transcriptomic changes and associates with ETS1 transcription factor
Get PDFDishevelled (DVL) is a crucial component of the Wnt-signaling pathway and is vital for multiple physiological processes. Previously thought to have a classically cytoplasmic role, the discovery of DVL nuclear translocation reframed how it is viewed functionally. Although significant progress has been made in understanding the nuclear functions of DVL, further research is required to clarify its roles in transcriptional and epigenetic regulation. A key unresolved question is whether nuclear DVL1 associates with a transcription factor partner. We show here that modulation of DVL1 expression globally affects the transcriptomic landscape. Additionally, analysis of DVL1 ChIP-sequencing allowed us to map genome-wide binding sites, revealing the extensive reach of DVL1 binding. Integration of RNA-sequencing and ChIP-sequencing further revealed ETS1 as a transcription factor binding partner which targets nuclear DVL1 to specific genomic loci. These findings provide insight into the contribution of DVL1 in transcription and clarify aspects of its elusive nuclear function
Time Alters Distinct Memories Driven by Sensory Prediction Errors and Task Errors in Sensorimotor Adaptation
Get PDFPrior learning can impair future learning when the requirements of the two memories conflict, a phenomenon termed anterograde interference. In sensorimotor adaptation, the passage of time between initial and future learning can reduce such interference effects, leading to the interpretation that time consolidates motor memories, protecting motor memories from interference. However, we still do not fully understand how time affects learning, as some studies found no effects of time on interference. One possible explanation for such inconclusive findings is that time has distinct effects on the multiple processes underpinning sensorimotor adaptation, and these processes may compensate for each other's effects on behaviour. Here, we used task manipulations that (1) dissociate adaptation processes driven by task errors from adaptation processes driven by sensory prediction errors and (2) separate the task-error driven adaptation processes into a flexible component that could not be acquired under time-pressure from a less flexible component that could be acquired under time-pressure. Consistent with interpretations from early reports, we found that the passage of time reduced anterograde interference effects in the adaptation component driven by sensory prediction errors. The passage of time between initial and subsequent learning also enhanced components of adaptation driven by task error: enhancing both the flexible, time-consuming component and the inflexible, time-efficient component driven by task errors. Thus, we provide evidence that multiple components of sensorimotor adaptation are sensitive to the passage of time