Systematic Screening and Assessment of Hospital-Based Youth Violence Prevention Programs.

Youth violence is a preventable public health issue. Few hospital-based programs intentionally focus on youth violence prevention. This project aimed to describe the Systematic Screening and Assessment (SSA) methodology used to identify existing hospital-based youth violence prevention (HBYVP) programs ready for future rigorous evaluation. To identify promising HBYVP programs currently in use and assess readiness for evaluation, data from the 2017 American Hospital Association (AHA) Annual Survey of Hospitals was used to identify hospitals with Level I-III trauma centers with reported HBYVP programs. Information for each program was gathered via environmental scan and key informant interviews. A total of 383 hospital-based violence prevention programs were identified. Two review panels were conducted with violence prevention experts to identify characteristics of programs suitable for an evaluability assessment (EA). Fifteen programs focused on youth (10-24 years old) and were identified to be promising and evaluable. Three of the 15 programs were determined to have the infrastructure and readiness necessary for rigorous evaluation. Lessons learned and best practices for SSA project success included use of streamlined outreach efforts that provide program staff with informative and culturally tailored project materials outlining information about the problem, project goals, proposed SSA activities, and altruistic benefit to the community at the initial point of contact. In addition, success of review panels was attributed to use of software to streamline panelist review processes and use of evaluation and data analysis subject matter experts to serve as panel facilitators. Communities experiencing high youth violence burden and hospitals serving these communities can improve health outcomes among youth by implementing and evaluating tailored HBYVP programs.

More than a Great Idea: Findings from the Profiles in Public Health Social Work Study.

Progress in refining the definition and basic concepts of public health social work (PHSW) is central to its revitalization. Advancing PHSW further depends on understanding the roles, domains, and daily activities of current PHSW practitioners in the contemporary workforce. The goal of the Profiles in PHSW Study is to explore how public health social workers conceptualize and locate their work. Using snowball sampling, 48 PHSW subjects with four or more years of professional experience were recruited; 34 (70.8%) participated. Qualitative survey responses were compiled and thematically analyzed; six themes emerged related to the nuances of integrating public health and social work, wide-ranging practice across systems and settings, leadership, visibility and viability, and recommendations for how to move PHSW forward. Findings suggest that intentional profession-wide integration of public health approaches into social work education, research, and practice is needed to strengthen the field's impact and role in advancing population health.

[Work and training conditions of young German physicians in internal medicine. Results of a nationwide survey by young internists from the German Society of Internal Medicine and the German Professional Association of Internists]. / Arbeits- und Weiterbildungsbedingungen deutscher Assistenzärztinnen und -ärzte in internistischer Weiterbildung.

BACKGROUND: Major transformations within the German healthcare system (e. g. implementation of the G-DRG system, growing focus on economic aspects, demographic changes) led to changes of work and training conditions of young internists and to criticism and dissatisfaction. So far, there is a lack of up-to-date and nationwide data analyzing these issues with focus on economic pressure and psychosocial strain. METHODS: The young internists of the two professional bodies conducted an online-based survey addressing all their members in training. The questionnaire covers five central areas of conflict. Furthermore, the model of effort-reward-imbalance (ERI) was applied to measure psychosocial strain at work. RESULTS: 1696 internists in training participated in the survey. Workdays characterized by high pace and workload do not leave much room for professional training as well as for family and research friendly working conditions. A relevant part of the affected physicians draws or at least considers personal consequences. Economical pressure is clearly noticeable. Psychosocial strain among the questioned internists is very high and conveys a risk for physicians' health and patients' quality of care. CONCLUSION: Adjustments of working and training conditions in internal medicine are necessary to preserve physicians health, high-quality medical treatment and to ensure an attractive working environment.

Previous experiences with illness and traumatic experiences: a specific risk factor for hypochondriasis?

BACKGROUND: Previous experiences with illness and traumatic experiences are considered as important risk factors for the development of health anxiety and hypochondriasis. However, empirical research is insufficient and lacks adequate comparison groups. OBJECTIVE: Therefore, we sought to determine whether experiences with illness and traumatic experiences are really specific risk factors for hypochondriasis. METHOD: In the current study, patients with the diagnosis of hypochondriasis (n = 80), patients with a primary anxiety disorder (n = 80), and healthy controls (n = 83) were investigated regarding their previous experiences with illness (self and other) and traumatic childhood experiences. RESULTS: We found that patients with hypochondriasis reported a higher level of experience with illness and with traumatic childhood experiences than healthy controls. However, no differences were found between patients with hypochondriasis and those with an anxiety disorder, regarding their level of experience with illness and traumatic experiences. CONCLUSIONS: Previous experiences with illness and traumatic childhood experiences did not prove to be specific risk factors for the development of hypochondriasis. The importance of both experiences with illness and traumatic experiences as risk factors, as considered in the Diagnostic and Statistical Manual and in established cognitive-behavioral models, does not seem to be supported empirically. Further research should therefore also consider other potential risk factors discussed in the literature.

Risk of coronary artery disease as influenced by variants of the human endothelin and endothelin-converting enzyme genes.

OBJECTIVE: The potent vasoconstrictor endothelin (ET) is generated by enzymatic cleavage catalyzed by the endothelin-converting enzyme 1 (ECE-1) and plays a crucial role in the regulation of vascular tone and endothelial function. Polymorphisms of the ET and ECE genes may contribute to the development and progression of coronary artery disease. Recently, we have shown the functional relevance of the +138 adenine ins/del polymorphism on ET-1 expression in vitro. The aim of our case-control study was to investigate the impact of known and novel variants of the ET and ECE genes on the risk of coronary artery disease in vivo. METHODS: In a prestudy, 36 single nucleotide polymorphisms in the ET-1, ET-2, ET-3 and ECE-1 genes were identified in 55 participants by sequencing analysis. Subsequently, 1000 matched pairs of angiographically confirmed coronary artery disease patients and hospital controls were genotyped for the eight most common or functionally relevant variants of the ET-1 (138 A ins/del, 2176T>G, 3660G>A, 5665G>T (Lys198Asn)) and ECE-1 gene (-854C>T, -839T>G, -377G>A, and exon 9 +2C>T). RESULTS: Carriers of at least one copy of the dysfunctional ET-1 5665 T allele were at increased risk of coronary artery disease (odds ratio 1.25; 95% confidence interval 1.03-1.52, P=0.025), particularly among men (odds ratio 1.32; 95% confidence interval 1.06-1.65, P=0.014). Homozygous carriers of the ECE-1 -839G variant allele exhibited a decreased risk of coronary artery disease (odds ratio 0.41; 95% confidence interval 0.18-0.90, P=0.024). The other six screened variants showed no association with coronary artery disease, the overall haplotype distribution differed slightly but significantly. CONCLUSIONS: This large case-control study argues for an only minor-if any-role of the ET-1 and ECE-1 genotype for the risk of coronary artery disease development.

CD133+ hepatic stellate cells are progenitor cells.

Hepatic stellate cells (HSC) play an important role in the development of liver fibrosis. Here, we report that HSC express the stem/progenitor cell marker CD133 and exhibit properties of progenitor cells. CD133+ HSC of rats were selected by specific antibodies and magnetic cell sorting. Selected cells displayed typical markers of HSC, endothelial progenitor cells (EPC), and monocytes. In cell culture, CD133+ HSC transformed into alpha-smooth muscle actin positive myofibroblast-like cells, whereas application of cytokines known to facilitate EPC differentiation into endothelial cells led to the formation of branched tube-like structures and induced expression of the endothelial cell markers endothelial nitric oxide synthase and vascular-endothelial cadherin. Moreover, cytokines that guide stem cells to develop hepatocytes led to the appearance of rotund cells and expression of the hepatocyte markers alpha-fetoprotein and albumin. It is concluded that CD133+ HSC are a not yet recognized progenitor cell compartment with characteristics of early EPC. Their potential to differentiate into endothelial or hepatocyte lineages suggests important functions of CD133+ HSC during liver regeneration.