Self-powered CH3NH3PbI3 perovskite photodiode with a noise-suppressible passivation layer of poly(methyl methacrylate).

Organohalide perovskite materials and related optoelectronic applications have drawn significant attention due to their promising high-performance photon-to-electricity conversion efficiencies. Herein, we demonstrate a highly sensitive self-powered perovskite-based photodetector created with a noise-current-suppressible passivation layer of poly(methyl methacrylate) (PMMA) at the interface between a CH3NH3PbI3 light-absorbing layer and a NiOx hole-transporting layer. Along with the defect passivation effect, the PMMA layer effectively diminishes unwanted carrier recombination losses at the interface, resulting in a significant reduction of the leakage/noise current. Consequently, without external bias, a remarkably high level of specific detectivity (∼4.5 × 1013 Jones from the dark current and ∼0.81 × 1012 Jones from the noise current) can be achieved due to the use of the PMMA passivation layer, greatly exceeding those of conventional unpassivated perovskite devices. Moreover, we observed a very wide linear dynamic response range of ∼129 dB together with rapid rise and decay response times of ∼52 and ∼18 µs, respectively. Overall, these results provide a solid foundation for advanced interface-engineering to realize high-performance self-powered perovskite photodetectors for various optoelectronic applications.

Feasibility of a Digital Storytelling Intervention for Hematopoietic Cell Transplant Patients.

Patients undergoing hematopoietic cell transplantation (HCT) are at risk for psychological and social impairment given the rigors and multiple sequelae of treatment. The purpose of this pilot study was to test the feasibility of a digital storytelling (DS) intervention for HCT patients, and to examine limited efficacy of the intervention relative to control arm on psychological distress and perceived social support. Adult HCT patients (n = 40, M age = 59.2 years) were enrolled immediately post-HCT and randomly assigned to either DS intervention or information control (IC). DS participants viewed four 3-min personal, emotionally rich digital stories, and IC condition participants viewed four videos containing information about post-HCT care. Feasibility regarding recruitment, enrollment efforts, and change scores from pre- to post-intervention (Δs) on depression, anxiety, and perceived social support were tracked. Fifty-four (51.4%) of 105 eligible patients consented. Forty (74%) patients completed the intervention. All but one completed the post-intervention assessments demonstrating that HCT patients can be recruited and retained for this intervention. On average, perceived social support increased for the DS group (Δ = 0.06) but decreased for the IC group (Δ = - 0.05). Anxiety and depression improved over time in both conditions. Viewing digital stories with content evoking emotional contexts similar to one's own health challenges may improve perceptions of social support among HCT patients. How DS can improve perceived social support for both short-term and longer-term sustained effects in a longitudinal study is an area ripe for additional investigation.

Recruitment and retention of underrepresented and vulnerable populations to research.

Per principles outlined in the Belmont Report, research involving human subjects should minimize risks to participants and maximize benefits to participants and society. Recruitment of participants should be equitable. Once enrolled, participants have the right to withdraw at any point. Researchers must balance these principles with pressures to meet enrollment goals and, in the context of repeated-measures designs, retain participants across time. The purpose of this perspective is to describe the approach and corresponding activities for recruiting and retaining underrepresented and vulnerable populations that are the focus of a transdisciplinary academic research center. To this effort, we offer diverse disciplinary backgrounds, experience working with a wide range of populations (from infants to older adults and across multiple health conditions), and spanning a variety of research designs. Effective strategies offered include partnering with community entities, approaching potential participants where they are and at a time of readiness, using population-appropriate modes of communication and data collection, conducting study activities in familiar settings and at convenient times, maintaining frequent contact, and offering meaningful incentives. These strategies are consistent with population-specific reports found in the extant literature and underscore their cross-cutting nature, with adaptations based on participant and community partner needs and preferences.

Feasibility and Acceptability of a 3-Day Group-Based Digital Storytelling Workshop among Caregivers of Allogeneic Hematopoietic Cell Transplantation Patients: A Mixed-Methods Approach.

Family caregivers are essential partners for patients undergoing hematopoietic cell transplantation (HCT). The caregiving role is emotionally, physically, and financially demanding. Intervention efforts to provide relief for caregiver stress during HCT are highly warranted. Storytelling interventions are accruing evidence for efficacy in therapeutic contexts. The purpose of this study was to conduct a 3-full consecutive day digital storytelling (DST) workshop to build knowledge on caregivers' lived experiences during HCT, to pilot test DST with a small group of HCT caregivers, and to demonstrate feasibility and acceptability using qualitative and quantitative measures. Six adult caregivers of allogeneic HCT recipients (mean age, 60.2 years) attended a 3-day DST program (66% female, 83% white). All successfully created their personal audiovisual digital story (2 to 3 minutes long) and completed a survey. All participants rated the DST workshop as highly acceptable and therapeutic (mean score 5, on a scale of 1 to 5). Group discussions and interviews with participants further demonstrated high satisfaction and acceptability of the workshop format, setting, process, and structure. The survey results showed decreases in anxiety and depression from before to after the DST workshop with all participants showing change in the expected direction. This study demonstrates the feasibility and acceptability of a 3-day DST workshop as a distress-relieving tool for HCT caregivers. Future research is needed to test the efficacy of DST relative to a control condition.

Integrative medicine therapeutic approaches to cancer care: patient preferences from focus groups.

PURPOSE: To understand patient preferences for integrative therapeutics and/or modalities during cancer care. METHODS: Cancer patients currently going through treatment were recruited from the Mayo Clinic in Arizona. Participants were asked to engage in 1 of 4 focus groups to understand preferences regarding integrative therapeutic modalities in cancer treatment. Focus group data were transcribed and analyzed using thematic analysis. Eighty-five percent of inter-coder reliability was achieved with four team investigators. RESULTS: Nineteen cancer patients participated in four focus groups with mixed cancer types (42% breast cancer), gender (53% female), and age (69% over age 60). Focus group analyses resulted in five themes with respect to preferences regarding integrative therapeutic modalities among cancer patients: (1) preference regarding accurate and congruent information; (2) preference regarding stress and symptom management; (3) preference regarding discussion of integrative therapies with healthcare providers (4) preference regarding support from family and friends; and (5) preference regarding personalized holistic care. CONCLUSIONS: Patients have a desire to discuss integrative therapeutic aspects of their cancer treatment with healthcare providers. Understanding patient preferences allows opportunity for oncology providers to increase awareness/education of integrative therapeutic modalities. Increased integrative therapeutic knowledge may best support recovery and increased quality of life. IMPLICATIONS: Qualitative research may facilitate understanding the scope of cancer patient preferences regarding the desire and use of integrative therapeutic modalities. A conceptual understanding of cancer patient preferences regarding integrative therapies and modalities may best inform successful direction and efficacy of treatment strategies.

Xenopus laevis FGF receptor substrate 3 (XFrs3) is important for eye development and mediates Pax6 expression in lens placode through its Shp2-binding sites.

Members of the fibroblast growth factor (FGF) family play important roles during various developmental processes including eye development. FRS (FGF receptor substrate) proteins bind to FGFR and serve as adapters for coordinated assembly of multi-protein complexes involved in Ras/MAPK and PI3 kinase/Akt pathways. Here, we identified Xenopus laevis Frs3 (XFrs3), a homolog of vertebrate Frs3, and investigated its roles during embryogenesis. XFrs3 is expressed maternally and zygotically with specific expression patterns throughout the early development. Knockdown of XFrs3 using a specific antisense morpholino oligonucleotide (MO) caused reduction of Pax6 expression in the lens placode, and defects in the eye ranging from microphthalmia to anophthalmia. XFrs3 MO-induced defects were alleviated by wild type XFrs3 or a mutant XFrs3 (XFrs3-4YF), in which the putative tyrosine phosphorylation sites served as Grb2-binding sites are mutated. However, another XFrs3 mutant (XFrs3-2YF), in which the putative Shp2-binding sites are mutated, could not rescue the defects of XFrs3 morphants. In addition, we found that XFrs3 is important for FGF or IGF-induced ERK activation in ectodermal tissue. Taken together, our results suggest that signaling through Shp2-binding sites of XFrs3 is necessary for the eye development in Xenopus laevis.

The role of social support and social networks in health information-seeking behavior among Korean Americans: a qualitative study.

INTRODUCTION: This study used social network theory to explore the role of social support and social networks in health information-seeking behavior among Korean American (KA) adults. METHODS: A descriptive qualitative study using a web-based online survey was conducted from January 2013 to April 2013 in the U.S. The survey included open-ended questions about health information-seeking experiences in personal social networks and their importance in KA adults. Themes emerging from a constant comparative analysis of the narrative comments by 129 of the 202 respondents were analyzed. RESULTS: The sample consisted of 129 KA adults, 64.7% female, with a mean age of 33.2 (SD = 7.7). Friends, church members, and family members were the important network connections for KAs to obtain health information. KAs looked for a broad range of health information from social network members, from recommendations and reviews of hospitals/doctors to specific diseases or health conditions. These social networks were regarded as important for KAs because there were no language barriers, social network members had experiences similar to those of other KAs, they felt a sense of belonging with those in their networks, the network connections promoted increased understanding of different health care systems of the U.S. system, and communication with these network connections helped enhance feelings of being physically and mentally healthy. CONCLUSIONS: This study demonstrates the important role that social support and personal social networks perform in the dissemination of health information for a large ethnic population, KAs, who confront distinct cultural challenges when seeking health information in the U.S. Data from this study also illustrate the cultural factors that influence health information acquisition and access to social support for ethnic minorities. This study provides practical insights for professionals in health information services, namely, that social networks can be employed as a channel for disseminating health information to immigrants.

Structurational divergence theory as explanation for troublesome outcomes in nursing communication.

Structurational divergence (SD) theory captures negative communication cycles resulting from interpenetration of incompatible meaning structures. It is estimated that 12-15% of practicing nurses suffer from a problematic level of SD. With a sample of 713 nurses (57 departments) in a large hospital, this study tests a model positing SD as a root explanation of nursing job satisfaction and turnover. A number of variables long presumed to be explanations for job satisfaction and turnover were hypothesized as mediators between SD and those outcomes. Path analysis showed support for burnout, role conflict, bullying, and organizational identification as useful mediators, explaining 68% of the variance in job satisfaction, and 45% in intentions to leave. The study also explores relationships between SD and hospital quality indicators. SD is a concern because it powerfully explains a number of poor outcomes and provides an underlying explanation for a number of factors that predict job satisfaction and turnover.

Nurses' perceptions of conflict as constructive or destructive.

AIMS: The aim of this study was to examine nurses' perceptions of constructive and destructive conflicts and their management among nurses. BACKGROUND: Conflict among nurses is common and has been associated with lack of collaboration, lack of communication and disruptive behaviour, with the potential to have negative impact teamwork. However, unlike the broader social science literature, positive views of conflict are scarce in the nursing literature. Given the various functions of conflict and the high stakes of ineffective conflict management in nursing, it is necessary to examine how nurses understand both sides of conflict: constructive and destructive. DESIGN: A qualitative descriptive design. METHODS: Data were collected from 34 full time nurses as part of a conflict skills training course offered over 6 months beginning in October 2009. Each participant was asked to write a weekly journal about conflicts in his/her work place. RESULT: Data yielded 163 entries (82 classified as constructive and 81 as destructive). Results showed that quality patient care and cooperative communication contributed to the perception that conflict is constructive in nature. The central underlying themes in nurses' perceptions of destructive conflict were time constraints, role conflict and power differences that are not managed through communication. CONCLUSION: This article helps to identify nursing perceptions of constructive and destructive conflict and to understand complexities nurses face during their interactions with other nurses, physicians and patients. The insight that constructive views are related to constructive processes provides an excellent opportunity for an educational intervention, so that we can educate nurses to analyse problems and learn how to manage conflict with effective collaborative processes.

Highly Efficient and Stable Self-Powered Perovskite Photodiode by Cathode-Side Interfacial Passivation with Poly(Methyl Methacrylate).

For several years now, organic-inorganic hybrid perovskite materials have shown remarkable progress in the field of opto-electronic devices. Herein, we introduce a cathode-side passivation layer of poly(methyl methacrylate) (PMMA) for a highly efficient and stable self-powered CH3NH3PbI3 perovskite-based photodiode. For effective noise-current suppression, the PMMA passivation layer was employed between a light-absorbing layer of CH3NH3PbI3 (MAPbI3) perovskite and an electron transport layer of [6,6]-phenyl-C61-butyric acid methyl ester. Due to its passivation effect on defects in perovskite film, the PMMA passivation layer can effectively suppress interface recombination and reduce the leakage/noise current. Without external bias, the MAPbI3 photodiode with the PMMA layer demonstrated a significantly high specific detectivity value (~1.07 × 1012 Jones) compared to that of a conventional MAPbI3 photodiode without a PMMA layer. Along with the enhanced specific detectivity, a wide linear dynamic response (~127 dB) with rapid rise (~50 µs) and decay (~17 µs) response times was obtained. Furthermore, highly durable dynamic responses of the PMMA-passivated MAPbI3 photodiode were observed even after a long storage time of 500 h. The results achieved with the cathode-side PMMA-passivated perovskite photodiodes represent a new means by which to realize highly sensitive and stable self-powered photodiodes for use in developing novel opto-electronic devices.

Molecular mechanism of Jmjd3-mediated interleukin-6 gene regulation in endothelial cells underlying spinal cord injury.

The inflammatory response contributes substantially to secondary injury cascades after spinal cord injury, with both neurotoxic and protective effects. However, epigenetic regulations of inflammatory genes following spinal cord injury have yet to be characterized thoroughly. In this study, we found that histone H3K27me3 demethylase Jmjd3 expression is acutely up-regulated in blood vessels of the injured spinal cord. We also observed up-regulation of Jmjd3 gene expression in bEnd.3 endothelial cells that were subjected to oxygen-glucose deprivation/reperfusion injury. When Jmjd3 was depleted by siRNA, oxygen-glucose deprivation/reperfusion injury-induced up-regulation of IL-6 was significantly inhibited. In addition, Jmjd3 associated with NF-κB (p65/p50) and CCAAT-enhancer-binding protein ß at the IL-6 gene promoter. The recruitment of Jmjd3 coincided with decreased levels of tri-methylated H3K27 as well as increased levels of mono-methylated H3K27 at the IL-6 gene promoter. Furthermore, Jmjd3 depletion did not result in significant changes of methylation level of H3K27 at the IL-6 gene promoter. Collectively, our findings imply that Jmjd3-mediated H3K27me3 demethylation is crucial for IL-6 gene activation in endothelial cells, and this molecular event may regulate acute inflammatory response and integrity of the blood-spinal cord barrier following spinal cord injury.

Regulation of XFGF8 gene expression through SRY (sex-determining region Y)-box 2 in developing Xenopus embryos.

Fibroblast growth factors (FGFs) function as mitogens and morphogens during vertebrate development. In the present study, to characterise the regulatory mechanism of FGF8 gene expression in developing Xenopus embryos the upstream region of the Xenopus FGF8 (XFGF8) gene was isolated. The upstream region of the XFGF8 gene contains two putative binding sites for the SRY (sex-determining region Y)-box 2 (SOX2) transcription factor. A reporter assay with serially deleted constructs revealed that the putative SOX2-binding motif may be a critical cis-element for XFGF8 gene activation in developing Xenopus embryos. Furthermore, Xenopus SOX2 (XSOX2) physically interacted with the SOX2-binding motif within the upstream region of the XFGF8 gene in vitro and in vivo. Depletion of endogenous XSOX2 resulted in loss of XFGF8 gene expression in midbrain-hindbrain junction, auditory placode, lens placode and forebrain in developing Xenopus embryos. Collectively, our results suggest that XSOX2 directly upregulates XFGF8 gene expression in the early embryonic development of Xenopus.

A Digital Storytelling Intervention for Vietnamese American Mothers to Promote Their Children's HPV Vaccination.

Despite higher rates of human papillomavirus (HPV)-associated cancer in Vietnamese Americans (VA), their vaccination rate remains low. Culturally grounded narratives incorporating culture-specific beliefs and practices may be a promising approach to promote HPV vaccination and potentially mitigate HPV-associated cancer disparities experienced by VAs. We codeveloped personal, audiovisual digital stories about HPV vaccination with VA mothers of vaccinated children, and examined the effects of the digital storytelling (DST) intervention on vaccination intention among VA mothers of unvaccinated children ages 11-14. The stories (3 minutes each) were produced in both English and Vietnamese through a 2-day workshop in collaboration with two VA first-generation immigrant mothers. A community sample of 114 VA mothers of unvaccinated children viewed the stories and filled out an anonymous survey before and after the intervention. Of these mothers (mean age = 41.5 years; SD = 5.4), 35.2% were immigrants, and about half (51%) reported having a child who received free or reduced-price lunch at school. After the intervention, changes in two items indicating mothers' positive attitudes toward HPV vaccination were significant. Mothers' intention to vaccinate their children increased from 53% to 74%; the difference was large (OR = 9.12; Cohen g = 0.40) and statistically significant, χ2(1, N = 114) = 17.63, P < 0.001. Mothers' scores on the narrative quality assessment scale were high, suggesting high levels of identification and engagement with the stories. This brief intervention using digital stories was feasible and showed preliminary effects on promoting VA mothers' intention to vaccinate their children against HPV. PREVENTION RELEVANCE: HPV vaccination has effectively prevented its related cancers. A culturally and linguistically congruent DST intervention targeting HPV vaccination can increase mothers' intention to vaccinate their children. See related Spotlight, p. 419.

Supportive Care Needs: Perspectives of Cancer Patients and Healthcare Providers.

This descriptive qualitative study was conducted to understand supportive care needs from the perspectives of cancer patients and their healthcare providers (HCPs). Data collected from a purposive sample of 15 individuals (eight cancer patients and seven HCPs) using individual semi-structured interviews (60-90 minutes) were analyzed using thematic analysis. Four themes emerged from interview data in both patients and their HCPs: (1) information and resources, (2) peer support groups, (3) support for caregivers, and (4) tailored care. These four themes were discussed with subtle differences between groups. In addition, communication with and among HCPs was discussed by patients, while survivorship was mentioned by HCPs. Findings from this study indicate that nurses and other HCPs should provide supportive care congruent with the needs, preferences, and priorities of cancer patients through active and bidirectional communication with patients as well as interdisciplinary collaboration, which may optimize patient outcomes and use of resources.

Latin dance and Qigong/Tai Chi effects on physical activity and body composition in breast cancer survivors: A pilot study.

BACKGROUND: Breast cancer survivors (BCS), particularly Latina BCS, experience weight gain and reduced physical activity (PA) post-treatment increasing the risk for recurrence. There is a lack of evidence on the intensity and type of PA needed to engage cultural subgroups and improve clinical outcomes. This study developed and piloted two non-traditional PA interventions among a diverse sample of BCS. METHODS: Twenty BCS (65% Latina; age 25-75) participated in a 2-arm parallel group-randomized pilot study to test the effects of an 8-week Latin dance and Qigong/Tai Chi intervention on PA and body composition. A seven-day pedometer protocol was used to measure steps/week and a bioelectric impedence scale was used to assess BMI and %body fat. T-tests were used to examine preliminary outcomes across both interventions and within intervention arms. RESULTS: There were no significant changes in steps/week, BMI, or %body fat across or in each separate intervention. A small effect size for increase in steps/day was found among participants in the Qigong/Tai Chi arm (0.10) and low-to-moderate effect sizes for reductions in % body fat overall (0.36), and separately for participants in Latin dance (0.26) and Qigong/Tai Chi (0.46). CONCLUSION: Latin dance and Qigong/Tai Chi are engaging and acceptable PA modalities that are promising for improving PA and body fat among diverse, high-risk BCS. Our findings highlight the need to continue to reach and engage high-risk BCS, including Latina survivors, using novel, culturally-sensitive PA interventions. Future studies should extend and more rigorously test these novel approaches to improving outcomes associated with recurrence.

Highly Efficient and Stable Organic Light-Emitting Diodes with Inner Passivating Hole-Transfer Interlayers of Poly(amic acid)-Polyimide Copolymer.

Ensuring the long-term stability of high-performance organic light-emitting diodes (OLEDs) has remained a great challenge due to their limited lifetime and durability. Herein, a novel functional interlayer consisting of a poly(amic acid)-polyimide copolymer is introduced for use in OLEDs. It is shown that an OLED sample with a polyimide-copolymer interlayer exhibits high peak brightness of nearly 96 000 cd m-2 and efficiency of ≈92 cd A-1 , much higher than those (≈73 000 cd m-2 and ≈83 cd A-1 ) of a well-organized reference OLED. Moreover, the growth of dark spots is strongly suppressed in the sample OLED and the device lifetime is extended considerably. Further, highly stable and uniform large-area OLEDs are successfully produced when using the interlayer. These improvements are ascribed not only to the excellent film-forming and hole-transferring properties but also to the inner passivating capability of the polyimide-copolymer interlayer. The results here suggest that the introduction of an inner passivating/encapsulating hole-transferable polyimide-copolymer interlayer together with conventional external encapsulation technology represents a promising breakthrough that enhances the longevity of high-performance next-generation OLEDs.

Randomized Controlled Trial of Storytelling vs Didactic Education Effects on Dietary Colorectal Cancer Risk Behaviors among Latinxs.

Dietary patterns associated with risk for colorectal cancer (CRC) may contribute to continuing health disparities in Latinx populations. Latinx from low-income communities, aged 25-65, were randomized to a 12-week storytelling-based intervention (ST) (n = 300) or didactic learning (DL)(n = 285) classes on cancer screening and dietary changes related to CRC risk facilitated by Latinx lay health workers (promotora/es de salud). Dietary intake was assessed pre-and post-intervention (24-hour dietary recall) with no significant differences found between ST and DL groups. Specific dietary changes in both groups included increases (p<.05) in dietary fiber (ST from 17.0 to 18.2; DL from 16.38 to 17.8 gms), calcium (ST from 715.7 to 781.9; DL 666.4 to 748.7 mgs), and vegetables (ST 2.5 to 2.8; DL 2.4 to 2.6 servings/day). Although between-intervention group effects were not significant, both culturally-adapted interventions were found to change a selection of key CRC-preventive dietary behaviors.

Physical Activity Among Predominantly White Middle-Aged and Older US Adults During the SARS-CoV-2 Pandemic: Results From a National Longitudinal Survey.

Background: The first COVID-19 case in the US was diagnosed late January 2020. In the subsequent months, cases grew exponentially. By March 2020, SARS-CoV-2 (the novel coronavirus that causes COVID-19) was a global pandemic and the US declared a national emergency. To mitigate transmission, federal guidelines were established for social and physical distancing. These events disrupted daily routines of individuals around the world, including Americans. The impact of the pandemic on PA patterns of Americans is largely unknown, especially among those at greater risk for severe COVID-19 outcomes. The aim of this study was to assess levels of PA over time during the pandemic among US adults aged >50 years. Methods: Data were collected as part of a web-based, longitudinal, 3-wave study examining health and well-being among adults aged > 50. PA data were collected at Waves 2 and 3 using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). At Wave 2 (conducted mid-May to early June, 2020), participants completed the IPAQ-SF twice, once in reference to a typical 7-day period before the pandemic, and again in reference to the past 7 days. At Wave 3 (conducted mid-June to early July 2020), participants completed the IPAQ-SF once, with reference to the past 7 days. Potential predictors of PA change were collected using items from previously established surveys and included demographic characteristics, pre-pandemic PA levels, perceived COVID-19 threat, self-rated general health, and number of chronic disease conditions. Results: Respondents (N = 589) had a mean age of 63 ± 7.39 years and were mostly female (88%) and non-Hispanic White (96%). Mean MET-min/week across the three time-referents were 2,904 (pre-pandemic), 1,682 (Wave 2 past 7-days), and 2,001 (Wave 3 past 7-days), with PA declining between the first and second time referents (d = -0.45, p < 0.001) and remaining below pre-pandemic levels at the third (d = -0.34, p < 0.001). Changes over time were predicted by pre-pandemic PA and self-rated general health (p's < .05). Conclusions: Effective strategies are needed to promote safe and socially-distanced PA among adults aged >50 years until the risk of contracting COVID-19 subsides. In the post-pandemic era, PA programming will be imperative to address pandemic-associated declines in PA.

Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement.

BACKGROUND: Advancements in early detection and treatment of cancer have led to increased survival rates and greater need to identify effective supportive care options for resolving symptoms of survivorship. Many non-pharmacological approaches to symptom management during and after cancer treatment involve emotional self-regulation as a central strategy for improving well-being. Identifying commonalities among these strategies' mechanisms of action may facilitate understanding of what might be useful for optimizing intervention effects. Heart rate variability (HRV) parameters are indicative of improved autonomic nervous system (ANS) balance and resiliency and reduced emotional distress and are thus identified as a mechanism to discuss as a marker of potential for intervention efficacy and a target for optimization. METHODS: HRV data from 2 studies, 1 examining a mind-body intervention and 1 examining a psychosocial intervention, are presented as a point of discussion about preliminary associations between the interventions, change in HRV, and emotional distress reduction. RESULTS: HRV significantly decreased in sympathetic activity in response to a mind-body intervention (Qigong/Tai Chi), and increased vagal tone in response to a psychosocial (storytelling) intervention. In both, these changes in HRV parameters were associated with improved emotional states. CONCLUSION: Our preliminary data suggest that HRV may serve as an important marker of underlying changes that mediate emotional regulation; this observation deserves further investigation. If identified as a worthy target, focusing on interventions that improve HRV within the context of interventions for cancer patients may be important to key outcomes and clinical practice.

Native American patients' perception and attitude about kidney transplant: a qualitative assessment of patients presenting for kidney transplant evaluation.

OBJECTIVE: Native Americans suffer from lower rates of kidney transplantation compared with whites. Our goal was to elicit patients' perceptions of and attitudes about kidney transplant and the impact of financial burden and cultural taboos. DESIGN: This is an exploratory qualitative interview study of 12 Native American patients recruited after completion of the kidney transplant evaluation. SETTING: Semistructured interviews were conducted. Interviews were coded using inductive methods, followed by interpretive coding by the investigators. RESULTS: Thematic analysis revealed the following themes: (1) experience with kidney transplant education by the healthcare team; (2) cultural beliefs regarding kidney transplant; (3) personal motivation and attitude towards kidney transplant; (4) financial burden of kidney transplant and post-transplant care and (5) attitude about living donation.Most participants were educated about transplant as a treatment option after dialysis initiation. All patients in this study recognised that some taboos exist about the process of organ procurement and transplantation; however, the traditional views did not negatively impact their decision to pursue kidney transplant evaluation. Patients shared the common theme of preferring an organ from a living rather than a deceased person; however, the majority did not have a living donor and preferred not to receive an organ from a family member. Most patients did not perceive transplant-related cost as negatively impacting their attitude about receiving a transplant even for patients with below poverty level income. CONCLUSIONS: Native American patients presenting for kidney transplant were less likely to be educated about transplant before dialysis initiation; did not perceive financial burden and cultural beliefs were not discussed as obstacles to transplant. While a living donor was the preferred option, enthusiasm for living donation from family members was limited.