Intrinsically Disordered Proteins Drive Emergence and Inheritance of Biological Traits.

Prions are a paradigm-shifting mechanism of inheritance in which phenotypes are encoded by self-templating protein conformations rather than nucleic acids. Here, we examine the breadth of protein-based inheritance across the yeast proteome by assessing the ability of nearly every open reading frame (ORF; ∼5,300 ORFs) to induce heritable traits. Transient overexpression of nearly 50 proteins created traits that remained heritable long after their expression returned to normal. These traits were beneficial, had prion-like patterns of inheritance, were common in wild yeasts, and could be transmitted to naive cells with protein alone. Most inducing proteins were not known prions and did not form amyloid. Instead, they are highly enriched in nucleic acid binding proteins with large intrinsically disordered domains that have been widely conserved across evolution. Thus, our data establish a common type of protein-based inheritance through which intrinsically disordered proteins can drive the emergence of new traits and adaptive opportunities.

Understanding the Experiences of Food Insecurity in Older Adult Households.

Food insecurity is a pressing multidimensional problem that negatively impacts the health and well-being of a significant number of the older population. Finding ways to better address nutritional issues among this vulnerable population is vital to their well-being. Using a mixed-methods approach, we conducted semi-structured phone interviews with a representative sample of 434 low-income older adult households in Tennessee. The aim of this study is to assess the prevalence of food insecurity, examine ongoing barriers, and, using qualitative data, to explore the diverse daily experiences older adults face when confronted with a food insecure lifestyle. Based on the USDA Adult 10-Item Household Screening Module, we found that 30% in our sample were designated as marginally, low or very low food secure. Many of those most vulnerable (older women, widowed or divorced, poor health and below the poverty line) constantly struggled with food insecurity. Being food insecure was attributed to limited financial resources, lack of transportation, health limitations, and a poor psychological state. Utilizing food stretching practicing, governmental agencies offering food supplements, family/friends, religious groups and personal resilience were common coping strategies. Implications and recommendations for service providers are offered.

The Role of the Dopamine Transporter in the Effects of Amphetamine on Sleep and Sleep Architecture in Drosophila.

The dopamine transporter (DAT) mediates the inactivation of released dopamine (DA) through its reuptake, and thereby plays an important homeostatic role in dopaminergic neurotransmission. Amphetamines exert their stimulant effects by targeting DAT and inducing the reverse transport of DA, leading to a dramatic increase of extracellular DA. Animal models have proven critical to investigating the molecular and cellular mechanisms underlying transporter function and its modulation by psychostimulants such as amphetamine. Here we establish a behavioral model for amphetamine action using adult Drosophila melanogaster. We use it to characterize the effects of amphetamine on sleep and sleep architecture. Our data show that amphetamine induces hyperactivity and disrupts sleep in a DA-dependent manner. Flies that do not express a functional DAT (dDAT null mutants) have been shown to be hyperactive and to exhibit significantly reduced sleep at baseline. Our data show that, in contrast to its action in control flies, amphetamine decreases the locomotor activity of dDAT null mutants and restores their sleep by modulating distinct aspects of sleep structure. To begin to explore the circuitry involved in the actions of amphetamine on sleep, we also describe the localization of dDAT throughout the fly brain, particularly in neuropils known to regulate sleep. Together, our data establish Drosophila as a robust model for studying the regulatory mechanisms that govern DAT function and psychostimulant action.

Predictors of chlamydia or gonorrhea among people with HIV in Miami-Dade County Ryan White Program in 2017.

The purpose of this study was to assess the prevalence of chlamydia or gonorrhea and factors associated with the diagnoses among people with HIV (PHIV) in the Ryan White Program Part A (RWP) in Miami-Dade County, Florida. We used 2017 calendar year data to identify factors associated with a chlamydia or gonorrhea diagnoses using logistic regression. About 50% of the 7110 PHIV who were ≥18 years old in active Ryan White care in 2017 reported being screened for chlamydia or gonorrhea. Of those screened, 2.3% reported diagnoses of chlamydia, gonorrhea or both. In the adjusted model, compared to PHIV ≥40 years-old, PHIV aged 18-24 and 25-39 years reported higher odds of diagnoses (adjusted odds ratio [aOR] 4.29; 95% confidence interval [CI]: 1.73-10.63 and aOR 4.58; 95% CI; 2.62-7.99 respectively). Those with multiple sexual partners in the last 12 months reported higher odds of diagnoses (aOR 1.67; (95% CI; 1.04-2.69)). Screening rates for chlamydia or gonorrhea are low, relative to CDC guidelines. Interventions are needed to increase rates of screening and targeted behavioral risk reduction techniques are highly recommended among those 18-39 years of age and those who have multiple sexual partners.

Australian lessons for developing and testing a culturally inclusive health promotion campaign.

The purpose of the study was to develop and test culturally appropriate health promotion materials that were seen to be socially inclusive in regard to blood donation within the Australian-African community. Materials were produced in multiple languages (English, Arabic, Swahili and Kirundi) and were initially developed based on previous pilot data, with feedback from the project partner (Australian Red Cross Blood Service) and the African community. Seven formative focus groups with 62 participants were then conducted to ensure the materials would be effective, credible and culturally acceptable to the target audience, including preferred messages, taglines and images. The response confirmed that quotes and images from community members (as opposed to actors) were critical to ensure messages were engaging and believable, and had meaningful taglines that were perceived to be authentic. The refined materials were then used in a community intervention study. The evaluation included an assessment of respondents' views of the messages post-intervention. Of the 281 African migrants who saw the campaign materials during the intervention period, the majority (75.8%) strongly agreed that the materials made them feel part of the wider Australian community. These results suggest that engagement in developmental activities with targeted communities is important for creating positively viewed culturally targeted public health campaigns. A six-step process is suggested that could be used by other organizations to ensure that messages are acceptable to targeted migrant communities.

Using Phosphatidylinositol Phosphorylation as Markers for Hyperglycemic Related Breast Cancer.

Studies have suggested that type 2 diabetes (T2D) is associated with a higher incidence of breast cancer and related mortality rates. T2D postmenopausal women have an ~20% increased chance of developing breast cancer, and women with T2D and breast cancer have a 50% increase in mortality compared to breast cancer patients without diabetes. This correlation has been attributed to the general activation of insulin receptor signaling, glucose metabolism, phosphatidylinositol (PI) kinases, and growth pathways. Furthermore, the presence of breast cancer specific PI kinase and/or phosphatase mutations enhance metastatic breast cancer phenotypes. We hypothesized that each of the breast cancer subtypes may have characteristic PI phosphorylation profiles that are changed in T2D conditions. Therefore, we sought to characterize the PI phosphorylation when equilibrated in normal glycemic versus hyperglycemic serum conditions. Our results suggest that hyperglycemia leads to: 1) A reduction in PI3P and PIP3, with increased PI4P that is later converted to PI(3,4)P2 at the cell surface in hormone receptor positive breast cancer; 2) a reduction in PI3P and PI4P with increased PIP3 surface expression in human epidermal growth factor receptor 2-positive (HER2+) breast cancer; and 3) an increase in di- and tri-phosphorylated PIs due to turnover of PI3P in triple negative breast cancer. This study begins to describe some of the crucial changes in PIs that play a role in T2D related breast cancer incidence and metastasis.

K2p 3.1 protein is expressed as a transmural gradient across the rat left ventricular free wall.

INTRODUCTION: K2p 3.1, also known as TASK-1, is a twin-pore acid-sensitive repolarizing K+ channel, responsible for a background potassium current that significantly contributes to setting the resting membrane potential of cardiac myocytes. Inhibition of IK2p3.1 alters cardiac repolarization and is proarrhythmogenic. In this study, we have examined the expression of K2p 3.1 and function of this channel in tissue and myocytes from across the left ventricular free wall. METHODS AND RESULTS: Using fluorescence immunocytochemistry, the expression of K2p 3.1 protein in myocytes from the subendocardial region was found to be twice (205% ± 13.5%) that found in myocytes from the subepicardial region of the left ventricle (100% ± 5.3%). The left ventricular free wall exhibited a marked transmural gradient of K2p 3.1 protein expression. Western blot analysis confirmed significantly higher K2p 3.1 protein expression in subendocardial tissue (156% ± 2.5%) than subepicardial tissue (100% ± 5.0%). However, there was no difference in K2p 3.1 messenger RNA expression. Whole-cell patch clamp identified IK2p3.1 current density to be significantly greater in myocytes isolated from the subendocardium (7.66 ± 0.53 pA/pF) compared with those from the subepicardium (3.47 ± 0.74 pA/pF). CONCLUSIONS: This is the first study to identify a transmural gradient of K2p 3.1 in the left ventricle. This gradient has implications for understanding ventricular arrhythmogenesis under conditions of ischemia but also in response to other modulatory factors, such as adrenergic stimulation and the presence of anesthetics that inhibits or activates this channel.

Assessment of Yersinia entomophaga as a control agent of the diamondback moth Plutella xylostella.

The application of the biocontrol bacterium Yersinia entomophaga as a foliar spray was assessed for its efficacy against larvae of the diamondback moth, Plutella xylostella. The bacterium was applied as either a broth suspension, or as a biopolymer-based gel foliar spray and compared with commercial insecticides Dipel (Bacillus thuringiensis) and Spinosad. The performance of Y. entomophaga was comparable with that of Dipel. The gel-based formulation extended leaf persistence over that of the basic broth culture spray, while also providing higher initial foliar deposition rates. The bacterium was found to multiply within the P. xylostella larvae to 5.8 × 105 cells per larva, while the median lethal dose (LD50) was determined to be 2.69 × 103 cells per larva. Importantly, B. thuringiensis Cry1A-resistant, Cry1C-resistant, indoxacarb/pyrethroid-resistant, and Spinosad-resistant P. xylostella larvae were susceptible to Y. entomophaga.

Serratia proteamaculans Strain AGR96X Encodes an Antifeeding Prophage (Tailocin) with Activity against Grass Grub (Costelytra giveni) and Manuka Beetle (Pyronota Species) Larvae.

A highly virulent Serratia proteamaculans strain, AGR96X, exhibiting specific pathogenicity against larvae of the New Zealand grass grub (Costelytra giveni; Coleoptera: Scarabaeidae) and the New Zealand manuka beetle (Pyronota festiva and P. setosa; Coleoptera: Scarabaeidae), was isolated from a diseased grass grub larva. A 12-day median lethal dose of 4.89 × 103 ± 0.92 × 103 cells per grass grub larva was defined for AGR96X, and death occurred within 5 to 12 days following the ingestion of a high bacterial dose. During the infection period, the bacterium rapidly multiplied within the insect host and invaded the hemocoel, leading to a mean bacterial load of 8.2 × 109 cells per larva at 6 days postingestion. Genome sequencing of strain AGR96X revealed the presence of a variant of the Serratia entomophila antifeeding prophage (Afp), a tailocin designated AfpX. Unlike Afp, AfpX contains two Afp16 tail-length termination protein orthologs and two putative toxin components. A 37-kb DNA fragment encoding the AfpX-associated region was cloned, transformed into Escherichia coli, and fed to C. giveni and Pyronota larvae, causing mortality. In addition, the deletion of the afpX15 putative chaperone component abolished the virulence of AGR96X. Unlike S. entomophila Afp, the AfpX tailocin could be induced by mitomycin C. Transmission electron microscopy analysis revealed the presence of Afp-like particles of various lengths, and when the purified AfpX tailocin was fed to grass grub or manuka beetle larvae, they underwent phenotypic changes similar to those of larvae fed AGR96X.IMPORTANCESerratia proteamaculans strain AGR96X shows dual activity against larvae of endemic New Zealand pasture pests, the grass grub (Costelytra giveni) and the manuka beetle (Pyronota spp.). Unlike Serratia entomophila, the causal agent of amber disease, which takes 3 to 4 months to kill grass grub larvae, AGR96X causes mortality within 5 to 12 days of ingestion and invades the insect hemocoel. AGR96X produces a unique variant of the S. entomophila antifeeding prophage (Afp), a cell-free phage-like entity that is proposed to deliver protein toxins to the grass grub target site, causing a cessation of feeding activity. Unlike other Afp variants, AGR96X Afp, named AfpX, contains two tail-length termination proteins, resulting in greater variability in the AfpX length. AfpX shows dual activity against both grass grub and manuka beetle larvae. AGR96X is a viable alternative to S. entomophila for pest control in New Zealand pasture systems.

Prions are a common mechanism for phenotypic inheritance in wild yeasts.

The self-templating conformations of yeast prion proteins act as epigenetic elements of inheritance. Yeast prions might provide a mechanism for generating heritable phenotypic diversity that promotes survival in fluctuating environments and the evolution of new traits. However, this hypothesis is highly controversial. Prions that create new traits have not been found in wild strains, leading to the perception that they are rare 'diseases' of laboratory cultivation. Here we biochemically test approximately 700 wild strains of Saccharomyces for [PSI(+)] or [MOT3(+)], and find these prions in many. They conferred diverse phenotypes that were frequently beneficial under selective conditions. Simple meiotic re-assortment of the variation harboured within a strain readily fixed one such trait, making it robust and prion-independent. Finally, we genetically screened for unknown prion elements. Fully one-third of wild strains harboured them. These, too, created diverse, often beneficial phenotypes. Thus, prions broadly govern heritable traits in nature, in a manner that could profoundly expand adaptive opportunities.

Patient consultation about a trial of therapeutic plasma exchange for complex regional pain syndrome.

BACKGROUND: Complex regional pain syndrome (CRPS) is a severe post-traumatic chronic pain condition affecting distal limbs, for which few effective treatments exist. Complex regional pain syndrome is listed in the 2016 American Society for Apheresis guidelines as an indication for plasma exchange treatment, but patient perspectives are lacking. STUDY DESIGN AND METHODS: We convened a "patient and public consultation exercise." Supervised by a clinical ethicist, the case for using therapeutic plasma exchange (TPE) was presented by a researcher and two TPE experts to five patients with severe, long-standing CRPS and to one relative. Discussions were recorded and transcribed. RESULTS: Participants supported the technology's use but expressed concern that the small trauma of repeat cannulations of CRPS unaffected limbs might theoretically cause a spread of the condition, a risk which requires highlighting when taking consent. For a preliminary trial, the participants proposed to include no less than 10, preferably 20 participants. They suggested that the threshold for a decision to conduct a definite trial based on preliminary trial results should be set no higher than 1/5 patients achieving >30% pain reduction in the preliminary trial, with half of these responders achieving >50%. The use of sham-TPE and a long trial duration (1 year) of a definite, parallel trial was considered acceptable, provided patients would be offered voluntary swap to the other trial arm at the end of the main trial period. CONCLUSION: These results provide pertinent patient views about TPE treatment which can inform both clinical consultation and consent procedure and the design of future trials.

'You could get sick, disgusting': an analysis of alcohol counter-advertisements created by children.

Advertisements are persuasive texts designed to communicate ideas explicitly and implicitly through visual grammar. Counter-advertisements allow students to engage with advertising texts as creators rather than consumers and challenge media messages. Based in critical media literacy theory, this paper explores how elementary students interpret and redesign advertisements to create meaning. This study focused on the messages upper-elementary school students created about alcohol following a 10-lesson alcohol media literacy programme. Text from the counter-advertisements (n = 161) was analysed using discourse analysis. The counter-advertisements were also content analysed for message content, persuasion strategies and production components using a media literacy framework. The content of male-targeted, female-targeted and gender-neutral ads was compared using chi-square analyses. The four main themes identified in the discourse and content analysis were 'vomit', 'sick', 'danger' and 'poison', highlighting an emphasis on short-term consequences of alcohol misuse. Sensory (un)appeal was the most frequently used persuasion strategy, while objects/symbols and colour were the most frequently used production components. The use of these devices differed depending upon the advertisement's target gender. Involving elementary students in the redesign of advertisements is a powerful pedagogy that enables students to demonstrate their understanding of media literacy practices and create health promotion messages.

Developing a Motion Comic for HIV/STD Prevention for Young People Ages 15-24, Part 1: Listening to Your Target Audience.

Young people (15-24 years) in the United States are disproportionately affected by infection with human immunodeficiency virus (HIV) and sexually transmitted diseases (STD). Shortfalls in HIV/STD-related knowledge, attitudes, beliefs, and behavioral intentions (KABI) likely contribute to this discrepancy. In this report we describe our experience developing a novel means of health communication combining entertainment-education theory and recent technological advances to create a HIV/STD-focused "motion comic." We also report the audience satisfaction and acceptance of the intervention. We used the Health Belief Model (HBM), entertainment-education (EE) principles, and the Sabido Method (SM) and conducted three rounds of focus groups to develop a 38-minute HIV/STD focused motion comic for young people between the ages 15 and 24 years. Participants indicated that motion comics were an acceptable method of delivering HIV/STD prevention messages. They also expressed satisfaction with motion comics plot, story settings, the tone of humor, and drama. Our results suggest that motion comics are a viable new method of delivering health communication messages about HIV/STD and other public health issues, and warrant further development and broader evaluation.

Are older Australians with chronic diseases online?

ISSUE ADDRESSED: Health information can be easily and cheaply provided through the Internet. However, we do not know whether older adults, those people most likely to be living with a chronic disease, are online or whether they use the Internet to find health information. METHODS: In order to establish the proportion of older Australians online, the impact of their current health status and chronic disease diagnosis on Internet usage and whether they use the Internet to search for health information, a paper-based survey was developed and mailed to 9000 older adults, resident in New South Wales, Australia (response rate = 46.8% ). RESULTS: Results showed that many older Australians are online (52.3%) and that the majority who are use the Internet to find health information (68.5%). Respondents were more likely to use the Internet if they reported good health. The presence of most chronic diseases reduced use of the Internet; however, this was not the case for those reporting asthma, anxiety or sleep apnoea. Internet use decreased as the number of reported co-morbidities increased. However, once online, self-perceived overall health and number of chronic diseases did not affect use of the Internet to find health information. CONCLUSIONS: This study is important as there is currently little information available about Internet use for health information by older Australians. Findings show that the provision of health information online has the potential to reinforce existing barriers created by the social determinants of health. SO WHAT?: There is a role for the Internet in providing preventative, health promotion information, to older adults, who are already online and younger, computer literate audiences. However, practitioners need to consider the fact that this mode of delivery reinforces existing social divides; requires people to have Internet access and be both literate and e-literate.

A systematic review of children's alcohol-related knowledge, attitudes and expectancies.

Understanding the nature of, and transitions in, young children's alcohol-related knowledge and attitudes is important to determining the age at which we should start educating children about alcohol and informing our understanding of the focus of such education. This paper aimed to explore current literature on the alcohol-related knowledge, beliefs, attitudes and expectancies of children aged 12years and under. Electronic databases were searched for papers published from January 2000-August 2016. Further papers were identified by a manual review of reference lists, and contacting corresponding authors of included papers. Papers that reported on children's knowledge or beliefs about alcohol, attitudes towards alcohol and/or expectancies regarding alcohol consumption were included. Seventeen cross-sectional, experimental or observational studies and seven longitudinal studies met the inclusion criteria. Data on key measures was tabulated. From a very young age children are aware of and able to identify alcohol, and have some knowledge of its effects; their attitudes become more positive with increasing age and these shifts appear to precede drinking initiation by some years. The small number of available studies, with different measures of knowledge, attitudes and expectancies, made assessment of bias unfeasible. Only three studies were published in the last five years. Children's knowledge of, and attitudes towards, alcohol form before they initiate alcohol use, and are likely acquired through observation. Alcohol-related education should commence before children begin drinking, and should encourage the delay of alcohol initiation, address social norms, and reduce positive expectancies.

Natural language processing systems for capturing and standardizing unstructured clinical information: A systematic review.

We followed a systematic approach based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify existing clinical natural language processing (NLP) systems that generate structured information from unstructured free text. Seven literature databases were searched with a query combining the concepts of natural language processing and structured data capture. Two reviewers screened all records for relevance during two screening phases, and information about clinical NLP systems was collected from the final set of papers. A total of 7149 records (after removing duplicates) were retrieved and screened, and 86 were determined to fit the review criteria. These papers contained information about 71 different clinical NLP systems, which were then analyzed. The NLP systems address a wide variety of important clinical and research tasks. Certain tasks are well addressed by the existing systems, while others remain as open challenges that only a small number of systems attempt, such as extraction of temporal information or normalization of concepts to standard terminologies. This review has identified many NLP systems capable of processing clinical free text and generating structured output, and the information collected and evaluated here will be important for prioritizing development of new approaches for clinical NLP.

Qualitative process evaluation of an Australian alcohol media literacy study: recommendations for designing culturally responsive school-based programs.

BACKGROUND: Alcohol media literacy programs seek to mitigate the potentially harmful effects of alcohol advertising on children's drinking intentions and behaviours through equipping them with skills to challenge media messages. In order for such programs to be effective, the teaching and learning experiences must be tailored to their specific cultural context. Media in the Spotlight is an alcohol media literacy program aimed at 9 to 12 year old Australian children. This study evaluates the process and implementation of the program, outlining the factors that facilitated and inhibited implementation. From this evaluation, a pedagogical framework has been developed for health professionals implementing culturally responsive programs in school settings. METHODS: Process measures included: semi-structured interviews with teachers before and after the program was implemented (n = 11 interviews), program evaluation questionnaires completed by children (n = 166), lesson observations completed by teachers (n = 35 observations), and reflective journal entries completed by the researcher (n = 44 entries). A thematic analysis approach was used to analyse all of the data sets using NVivo. Inductive coding was used, whereby the findings were derived from the research objectives and multiple readings and interpretations of the data. RESULTS: Five key pedagogical considerations were identified that facilitated implementation. These were: connecting to the students' life worlds to achieve cultural significance; empowering students with real-world skills to ensure relevance; ensuring programs are well structured with strong connections to the school curriculum; creating developmentally appropriate activities while providing a range of assessment opportunities; and including hands-on and interactive activities to promote student engagement. Three potential inhibitors to implementing the alcohol media literacy program in upper-elementary school classrooms were identified. These included topic sensitivities, classroom management challenges, and fitting new programs into already busy school schedules. CONCLUSION: Overall, the program content and individual lessons were well received by the teachers and students. The lessons learned from the development, implementation and evaluation of this program can provide health professionals with key pedagogical strategies for designing culturally responsive educational programs. Culturally responsive programs are critical for ensuring interventions are effective for their specific context.

Association Between Young Australian's Drinking Behaviours and Their Interactions With Alcohol Brands on Facebook: Results of an Online Survey.

AIMS: To examine the association of alcohol-brand social networking pages and Facebook users' drinking attitudes and behaviours. METHODS: Cross-sectional, self-report data were obtained from a convenience sample of 283 Australian Facebook users aged 16-24 years via an online survey. RESULTS: More than half of the respondents reported using Facebook for more than an hour daily. While only 20% had actively interacted with an alcohol brand on Facebook, we found a significant association between this active interaction and alcohol consumption, and a strong association between engagement with alcohol brands on Facebook and problematic drinking. CONCLUSIONS: The findings of this study demonstrate the need for further research into the complex interaction between social networking and alcohol consumption, and add support to calls for effective regulation of alcohol marketing on social network platforms.

Lost in translation: a focus group study of parents' and adolescents' interpretations of underage drinking and parental supply.

BACKGROUND: Reductions in underage drinking will only come about from changes in the social and cultural environment. Despite decades of messages discouraging parental supply, parents perceive social norms supportive of allowing children to consume alcohol in 'safe' environments. METHODS: Twelve focus groups conducted in a regional community in NSW, Australia; four with parents of teenagers (n = 27; 70 % female) and eight with adolescents (n = 47; 55 % female). Participants were recruited using local media. Groups explored knowledge and attitudes and around alcohol consumption by, and parental supply of alcohol to, underage teenagers; and discussed materials from previous campaigns targeting adolescents and parents. RESULTS: Parents and adolescents perceived teen drinking to be a common behaviour within the community, but applied moral judgements to these behaviours. Younger adolescents expressed more negative views of teen drinkers and parents who supply alcohol than older adolescents. Adolescents and parents perceived those who 'provide alcohol' (other families) as bad parents, and those who 'teach responsible drinking' (themselves) as good people. Both groups expressed a preference for high-fear, victim-blaming messages that targeted 'those people' whose behaviours are problematic. CONCLUSIONS: In developing and testing interventions to address underage drinking, it is essential to ensure the target audience perceive themselves to be the target audience. If we do not have a shared understanding of underage 'drinking' and parental 'provision', such messages will continue to be perceived by parents who are trying to do the 'right' thing as targeting a different behaviour and tacitly supporting their decision to provide their children with alcohol.

Factors influencing young people's use of alcohol mixed with energy drinks.

A growing evidence base demonstrates the negative health outcomes associated with the consumption of energy drinks (ED) and alcohol mixed with energy drinks (AMED), especially among young people. Work to date has focused on the physiological effects of ED and AMED use and the motivations associated with consumption, typically among college students. The present study adopted an exploratory, qualitative approach with a community sample of 18-21 year olds to identify relevant barriers, motivators, and facilitators to AMED use and to explicate the decision-making processes involved. The sensitisation method was used to collect data from a cohort of 60 young adult drinkers over a period of six months via individual interviews, focus groups, and introspections. The findings indicate that there may be a general understanding of the negative consequences of AMED use, and that these consequences can constitute barriers that serve to discourage frequent consumption among young people. This outcome suggests the potential application of positive deviance and social norms approaches in interventions designed to reduce AMED use among this population segment. The results are promising in the identification of a large number of concerns among young adults relating to AMED use. These concerns can constitute the focus of future communications with this target group. The results are likely to have relevance to other countries, such as the US and the UK, that share similar alcohol cultures and where energy drinks have achieved comparable market penetration rates.