Social eating initiatives and the practices of commensality.

Social eating initiatives are a mode of food provisioning and eating that have become increasingly popular in the UK. These organisations provide a menu of low-cost meals prepared using food surpluses and deliberately serve food communally to improve social inclusion. Although these community initiatives have grown rapidly in popularity, research into their value from the perspective of participants is currently limited. This article presents data from a concurrent multi-method study conducted across multiple sites of the Nottingham Social Eating Network to explain the emergence of these novel social configurations. The results show this form of commensality, or group eating practice, is not simply a consequence of reducing food waste or food insecurity. Instead these initiatives are enacted through a series of intersecting social practices, which include: the restructuration of the shared mealtime; alimentary contribution; and performances of care. The findings provide important insights into the values expressed in these emergent initiatives and are therefore useful for framing social eating in public policy.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) affects gene expression pathways beyond cholesterol metabolism in liver cells.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) induces degradation of low-density lipoprotein receptor (LDLR) in the liver. It is being pursued as a therapeutic target for LDL-cholesterol reduction. Earlier genome-wide gene expression studies showed that PCSK9 over-expression in HepG2 cells resulted in up-regulation of genes in cholesterol biosynthesis and down-regulation of genes in stress response pathways; however, it was not known whether these changes were directly regulated by PCSK9 or were secondary to PCSK9-induced changes to the intracellular environment. In order to further understand the biological function of PCSK9 we treated HepG2 cells with purified recombinant wild type (WT) and D374Y gain-of-function PCSK9 proteins for 8, 24, and 48 h, and used microarray analysis to identify genome-wide expression changes and pathways. These results were compared to the changes induced by culturing HepG2 cells in cholesterol-free medium, mimicking the intracellular environment of cholesterol starvation. We determined that PCSK9-induced up-regulation of cholesterol biosynthesis genes resulted from intracellular cholesterol starvation. In addition, we identified novel pathways that are presumably regulated by PCSK9 and are independent of its effects on cholesterol uptake. These pathways included "protein ubiquitination," "xenobiotic metabolism," "cell cycle," and "inflammation and stress response." Our results indicate that PCSK9 affects metabolic pathways beyond cholesterol metabolism in HepG2 cells.

Component structure of individual differences in true and false recognition of faces.

Principal-component analyses of 4 face-recognition studies uncovered 2 independent components. The first component was strongly related to false-alarm errors with new faces as well as to facial "conjunctions" that recombine features of previously studied faces. The second component was strongly related to hits as well as to the conjunction/new difference in false-alarm errors. The pattern of loadings on both components was impressively invariant across the experiments, which differed in age range of participants, stimulus set, list length, facial orientation, and the presence versus absence of familiarized lures along with conjunction and entirely new lures in the recognition test. Taken together, the findings show that neither component was exclusively related to discrimination, criterion, configural processing, featural processing, context recollection, or familiarity. Rather, the data are consistent with a neuropsychological model that distinguishes frontal and occipitotemporal contributions to face recognition memory. Within the framework of the model, findings showed that frontal and occipitotemporal contributions are discernible from the pattern of individual differences in behavioral performance among healthy young adults.

Comparison of cursive handwriting instruction programs among students without identified problems.

The purpose of this study was to compare the effects of cursive handwriting programs in improving letter legibility and form in third-grade students without identified handwriting problems. Four months into the school year, cursive handwriting was assessed for a sample of convenience of 50 third-grade students. Subsequently, students received instruction for 10-15 minutes daily for 6 weeks using either Handwriting without Tears, Loops and Other Groups programs, or, as a control condition, continued instruction in the Zaner-Bloser program. Student handwriting for all programs improved from pretest to posttest. Posttest comparisons indicated no significant differences between programs. The results suggest that the method of handwriting instruction has a limited short-term impact on cursive letter legibility and form for children without handwriting problems.

A New Era in Pediatric Hospice Care for Military Families.

: This series on palliative care is developed in collaboration with the Hospice and Palliative Nurses Association (HPNA; https://advancingexpertcare.org). The HPNA aims to guide nurses in preventing and relieving suffering and in giving the best possible care to patients and families, regardless of the stage of disease or the need for other therapies. The HPNA offers education, certification, advocacy, leadership, and research.

Human NPC1L1 and NPC1 can functionally substitute for the ncr genes to promote reproductive development in C. elegans.

The NPC1 and NPC1L1 are related genes whose general role is in cholesterol trafficking. However, reduction of activity of these genes results in very different phenotypes. Niemann-Pick C disease type 1 is a neurodegenerative disease with no current treatment, where cholesterol accumulates in lysosomes. The disease arises due to autosomal recessive mutations in the NPC1 gene. The NPC1L1 gene has recently been identified as the target for the drug ezetimibe (Zetia), a cholesterol absorption inhibitor, and has been shown to be an intestinal cholesterol transporter. We demonstrate that human NPC1L1, as well as human NPC1, can functionally substitute for the Caenorhabditis elegans genes ncr-1 and/or ncr-2. These genes are known to play a role in the process of dauer formation, a process which can be modulated by cholesterol in sensitized genetic backgrounds. Our results demonstrate that these human proteins retain some functional conservation, though their biological roles are vastly different.

Road to Home Program: A Performance Improvement Initiative to Increase Family and Nurse Satisfaction With the Discharge Education Process for Newly Diagnosed Pediatric Oncology Patients [Formula: see text].

Families of children, adolescents, and young adults with a new oncology diagnosis must absorb knowledge and skills needed to care for their child at home during a period of emergent hospitalizations and intense medical interventions. Effective nurse-led teaching and discharge planning begun at diagnosis can prepare families to safely care for their child following discharge, and be a source of satisfaction. The objective of this performance improvement initiative was to increase family and nurse satisfaction with new diagnosis education and discharge. Using standard performance improvement techniques, family and nursing stakeholder satisfaction with current processes was assessed. Working from established best practice and literature review; The Road to Home was designed and implemented. This novel, comprehensive program includes a visual, interactive display of required education based on the Children's Oncology Group Family Handbook© and hospital specific discharge materials; standardized teaching, tools and documentation for nursing; and caregiver discharge tool kits. Stakeholder input guided improvement strategies throughout the phases of implementation. Sustained increases in family and nurse satisfaction resulted from each phase. The Road to Home program is established for all families of newly diagnosed oncology patients and is meeting goals of increased family and nurse satisfaction with discharge education.

Reversible posterior leukoencephalopathy, cerebral vasoconstriction, and strokes after intravenous immune globulin therapy in guillain-barre syndrome.

The authors report a patient with Guillain-Barré syndrome who developed acute hypertension, reversible posterior leukoencephalopathy syndrome, ischemic and hemorrhagic strokes, and reversible cerebral arterial vasoconstriction shortly after initiating intravenous immune globulin therapy. Possible interrelationships and mechanisms of these complications are discussed.

Movement disorders in pregnancy.

Movement disorders are not particularly common during pregnancy, with a few exceptions. RLS occurs most commonly followed by CG. Currently, with the incidence of rheumatic fever lower than previously, any woman who develops CG should be checked for illness other than rheumatic heart disease. The differential includes systemic lupus erythromatosis and antiphospholipid antibody syndrome. Regarding the use of dopaminergic agents, the dopamine agonist, pergolide, can be maintained during pregnancy for the treatment of PD, Segawa disease, and RLS. The use of levodopa and ropinirole should be limited during pregnancy because of the possible teratogenic effects. Amantadine is contraindicated during pregnancy. The data on selegiline are controversial; animal studies show possible serotonergic effects and teratogenic effects. If treatment is indicated in patients who have Tourette syndrome, the high potency neuroleptics drugs (haloperidol) are preferred to treat associated symptoms. Depression is a common comorbidity in patients who have PD, HD,Tourette syndrome, or other chronic neurologic diseases. Depression treatment during pregnancy is covered by Levy et al elsewhere in this issue. As discussed previously, most of the data on the use of drugs during pregnancy, especially the dopaminergic agents, are limited to animal studies and case reports. Therefore, it is in part left to the neurologist to decide on treatment based on the individual patient, clinical judgment, and inferences from animal studies and limited case reports.

Hormonal contraception and risk of bacterial vaginosis diagnosis in an observational study of women attending STD clinics in Baltimore, MD.

BACKGROUND: The protective effect of hormonal contraception may offer a potential intervention against bacterial vaginosis (BV). STUDY DESIGN: Three hundred thirty reproductive-age women enrolled in a contraceptive program from April 2005 to October 2006 at two sexually transmitted diseases clinics in Baltimore, MD. Participants were supplied with hormonal contraceptives of their choice and followed prospectively. BV was diagnosed by Amsel's criteria. Results from population-level analysis were compared to a case-crossover analysis. RESULTS: BV was diagnosed in 189 (13.0%) of the visits among 133 (40.3%) women. In the population-level analysis, the use of progestin-only and combined contraception was associated with a decreased risk of BV compared to intervals of no hormonal contraceptive use [adjusted odds ratio (AOR): 0.42 (95% CI: 0.20-0.88) and AOR: 0.66 (95% CI: 0.39-1.10), respectively]. The case-crossover analysis demonstrated a similar trend in findings. CONCLUSION: Hormonal contraception was associated with a decreased risk of BV in an STD clinic cohort.

Functional outcomes post carpal tunnel release: a modified replication of a previous study.

STUDY DESIGN: Exploratory cohort study. INTRODUCTION: To compares the outcome of self-administered questionnaires and physical measures in assessing change in function for participants after carpal tunnel surgery. METHODS: The self-administered questionnaires were the Carpal Tunnel Questionnaire (CTQ), the Disabilities of the Arm, Shoulder, and Hand (DASH), and Short Form-36. The physical measures were grip, pinch, range of motion, sensibility, and dexterity. Twenty-nine participants from five hand clinics were enrolled in the study. RESULTS: The results revealed that self-administered questionnaires were sensitive to change in function and three of ten physical measures showed a change in function. CONCLUSIONS: The authors concluded that select physical measures coupled with a disease-specific assessment, such as the CTQ and a region-specific questionnaire, such as the DASH would result in a comprehensive assessment of outcomes. This combination of assessments provides both physical measures of recovery and measures of perceived level of function. LEVEL OF EVIDENCE: 4.

Movement disorders in pregnancy.

Movement disorders are not commonly seen during pregnancy. As a result, there are few studies on whether disease manifestations are affected by the hormonal changes that occur during pregnancy or on the teratogenicity of commonly used medications for movement disorders on the developing fetus. This article discusses movement disorders that are seen only during pregnancy (chorea gravidarum) or that may present during pregnancy (restless legs syndrome), the effect that pregnancy has on symptoms and treatment (in Parkinson's disease, essential tremor, dystonia, tic disorders, and Wilson's disease), and the role of genetic testing for movement disorders in genetic counseling for pregnant women.

The target of ezetimibe is Niemann-Pick C1-Like 1 (NPC1L1).

Ezetimibe is a potent inhibitor of cholesterol absorption that has been approved for the treatment of hypercholesterolemia, but its molecular target has been elusive. Using a genetic approach, we recently identified Niemann-Pick C1-Like 1 (NPC1L1) as a critical mediator of cholesterol absorption and an essential component of the ezetimibe-sensitive pathway. To determine whether NPC1L1 is the direct molecular target of ezetimibe, we have developed a binding assay and shown that labeled ezetimibe glucuronide binds specifically to a single site in brush border membranes and to human embryonic kidney 293 cells expressing NPC1L1. Moreover, the binding affinities of ezetimibe and several key analogs to recombinant NPC1L1 are virtually identical to those observed for native enterocyte membranes. KD values of ezetimibe glucuronide for mouse, rat, rhesus monkey, and human NPC1L1 are 12,000, 540, 40, and 220 nM, respectively. Last, ezetimibe no longer binds to membranes from NPC1L1 knockout mice. These results unequivocally establish NPC1L1 as the direct target of ezetimibe and should facilitate efforts to identify the molecular mechanism of cholesterol transport.

The Caenorhabditis elegans homolog of the putative prostate cancer susceptibility gene ELAC2, hoe-1, plays a role in germline proliferation.

The potential prostate cancer susceptibility gene ELAC2 has a Caenorhabditis elegans homolog (which we call hoe-1, for homolog of ELAC2). We have explored the biological role of this gene using RNAi to reduce gene activity. We found that worms subjected to hoe-1 RNAi are slow-growing and sterile. The sterility results from a drastic reduction in germline proliferation and cell-cycle arrest of germline nuclei. We found that hoe-1 is required for hyperproliferation phenotypes seen with mutations in three different genes, suggesting hoe-1 may be generally required for germline proliferation. We also found that reduction of hoe-1 by RNAi suppresses the multivulva (Muv) phenotype resulting from activating mutations in ras and that this suppression is likely to be indirect. This is the first demonstration of a biological role for this class of proteins in a complex eukaryote and adds important information when considering the role of ELAC2 in prostate cancer.