Engineering antigen-specific T cells from genetically modified human hematopoietic stem cells in immunodeficient mice.

There is a desperate need for effective therapies to fight chronic viral infections. The immune response is normally fastidious at controlling the majority of viral infections and a therapeutic strategy aimed at reestablishing immune control represents a potentially powerful approach towards treating persistent viral infections. We examined the potential of genetically programming human hematopoietic stem cells to generate mature CD8+ cytotoxic T lymphocytes that express a molecularly cloned, "transgenic" human anti-HIV T cell receptor (TCR). Anti-HIV TCR transduction of human hematopoietic stem cells directed the maturation of a large population of polyfunctional, HIV-specific CD8+ cells capable of recognizing and killing viral antigen-presenting cells. Thus, through this proof-of-concept we propose that genetic engineering of human hematopoietic stem cells will allow the tailoring of effector T cell responses to fight HIV infection or other diseases that are characterized by the loss of immune control.

Why some adolescents lose weight and others do not: a qualitative study.

OBJECTIVES: Understanding the experiences of overweight adolescents who have lost weight may be useful in the creation of effective weight loss programs. Our objective was to identify differences between the experiences of overweight, inner-city adolescents who lost weight compared to adolescents who gained weight over time. METHODS: A qualitative study of a convenience sample of overweight inner-city adolescents, comparing those whose body mass index (BMI)-for-age decreased to those whose BMI-for-age increased, was done over a period of 2 years. Focus groups and in-depth interviews were analyzed by the constant comparative method; frequencies of thematic responses were compared. RESULTS: Adolescents in both groups had poor diets, had similar rates of eating with parents, had complex effects of monetary constraints, had ambivalence about being overweight, and lived in unsafe neighborhoods. Weight-losing adolescents were more likely to describe a transformative experience, which changed their view of themselves in the world with regard to weight and activity; to engage in intense, daily exercise; and to have family members who supported healthy dietary behavior. CONCLUSION: Transformative experiences, intense daily exercise, and family support appeared to be critical elements for weight reduction in inner-city adolescents. This information may guide the development of weight loss strategies.

Acknowledging adult bias: a focus-group approach to utilizing beauty salons as health-education portals for inner-city adolescent girls.

To assess the feasibility of using beauticians as health literacy agents and beauty salons as health-education portals for adolescent, inner-city, African American girls, the authors conducted focus groups with 25 women: salon clients, salon owners, and medical students. Facilitators to program development included (a) beautician-client relationships, (b) teens' access to health information, and (c) beauticians as information resources. Barriers included (a) adult opinions of teen behaviors, (b) teen mistrust of adults, and (c) low health literacy of beauticians. In developing a health-education program for this population, beauticians and salons may be excellent health information agents and portals if barriers including beautician poor health literacy, adolescent mistrust in adults, and adults' anti-adolescent bias are improved. Program implementation must not solely focus on teens but should also include adult salon users, with the goal of reaching the teens first through these adults and, with time and trust, reaching the teens directly.

Primary ambulatory care of overweight children.

Pediatric practitioners are getting closer to an evidence-based consensus on the diagnosis of obesity and on its sequelae through a structured best-practices approach, as outlined above, but much more research into actual treatment is needed. The long-term solution to overweight in childhood probably lies in a society-wide intervention, but what will be successful is not yet known. Currently, we are restricted to evidence-based treatment of the comorbidities, but we do not yet know how to treat weight successfully.