Qualitative analysis of health literacy: exploring a Kenyan community's response to childhood illness.

Parents are the first-line healthcare providers for their children and, thus, need to identify and treat symptoms, including knowing whether and how to seek treatment from healthcare professionals. In addition to the tangible resources necessary to address childhood illness, parents' health literacy skills impact their treatment decisions. The current study considered data gathered through focus groups (N = 9 groups) and key informant interviews (N = 13) to explore approaches to childhood illness and their implications for health literacy among Kenyan parents of young children (birth to age 5). Participants included parents, community health workers and community leaders (e.g. village elders) from the Kibera community in Kenya. Themes, resulting from the qualitative data analysis, were mapped onto the Research Triangle Institute's Health Literacy Skills Framework. Participants were well able to identify health risks, often turned to family and neighbors for medical advice, and relied on a range of resources to treat and prevent illnesses in their children. This range included reliance on traditional healers and religious leaders. Balancing cultural and medical viewpoints will be important considerations for interventions focused on supporting Kenyan parents' health literacy and skills to recognize and intervene when their children are sick.

To better understand health literacy among Kenyan parents with young children, 91 individuals (parents, community leaders, healthcare providers) provided information about children's common health concerns and how families address those concerns. The information is consistent with the Health Literacy Skills Framework and illuminated parents' strengths along with the need to balance cultural and medical viewpoints to improve parents' health literacy.

Targeting memory reconsolidation to prevent the return of fear in patients with fear of flying.

BACKGROUND: When a memory is recalled, it may again exist in a labile state and stored information becomes amenable to change, a psychobiological process known as reconsolidation. Exposure therapy for anxiety disorders involves accessing a fear memory and modifying it with less fearful information. A preclinical study reported that providing a reminder of a fear memory 10 min prior to extinction training in humans decreased fear up to 1 year later (Schiller et al., 2010). METHODS: For this pilot clinical study, we used virtual reality exposure therapy (VRE) for fear of flying (FoF) to determine if using a cue to reactivate the memory of the feared stimulus 10 min prior to exposure sessions leads to fewer anxiety-related behaviors and a more durable response compared to a neutral cue. FoF participants (N = 89) received four sessions of anxiety management training followed by four sessions of VRE. Participants were randomly assigned to receive an FoF cue (reactivation group) or a neutral cue (control group) prior to the VRE sessions. Heart rate (HR) and skin conductance levels (SCLs) were collected during posttreatment and 3-month follow-up assessments as objective markers of fear responding. RESULTS: Treatment was effective and all clinical measures improved equally between groups at posttreatment with maintained gains through follow-ups. Significant differences were identified with regard to HR and SCL indices. CONCLUSIONS: These results suggest that memory reactivation prior to exposure therapy did not have an impact on clinical measures but may enhance the effect of exposure therapy at the physiological level.

Hidden structural order in orthorhombic Ta2O5.

We investigate using first-principles calculations the atomic structure of the orthorhombic phase of Ta(2)O(5). Although this structure has been studied for decades, the correct structural model is controversial owing to the complication of structural disorder. We identify a new low-energy high-symmetry structural model, where all Ta and O atoms have the correct formal oxidation states of +5 and -2, respectively, and the experimentally reported triangular lattice symmetry of the Ta sublattice appears dynamically at finite temperatures. To understand the complex atomic structure of the Ta(2)O(3) plane, a triangular graph-paper representation is devised and used alongside oxidation state analysis to reveal infinite variations of the low-energy structural model. The structural disorder of Ta(2)O(5) observed in experiments is attributed to the intrinsic structural variations, and oxygen vacancies that drive the collective relaxation of the O sublattice.

Density functional calculations on the mechanical properties of nitrogen or oxygen doped crystalline Ge2Sb2Te5.

The mechanical properties of pure and doped crystalline Ge2Sb2Te5 were investigated by using density functional calculations. Nitrogen or oxygen was added at either the interstitial or substitutional sites of cubic Ge2Sb2Te5. The lattice parameter, elastic stiffness and related moduli were investigated from the viewpoint of the doping concentration, dopant species, dopant states and film direction. The effect of the doping concentration was more dominant than those of the dopant species and their states on the non-directionality properties, such as the bulk modulus and lattice parameter. It turned out that Ge2Sb2Te5 became slightly more rigid as the doping concentration of nitrogen or oxygen increased. On the other hand, the effect of the film direction on the directional properties, such as the biaxial modulus of the Ge2Sb2Te5 film, was found to be more predominant than that of doping. The biaxial modulus of the (001) oriented film was calculated to be much higher than those of the other films, indicating that the (001) film is the most vulnerable to thermal stress.

Implementing a multisite efficacy trial to facilitate maternal disclosure to children: the TRACK HIV Disclosure Intervention.

HIV remains prevalent, stigmatized, and requires parents to decide whether and how to disclose to their serostatus to their children. Teaching Raising And Communicating with Kids (TRACK), an intervention to support maternal disclosure of HIV status to children, demonstrated efficacy through a pilot and a full-scale multisite trial. In response to the limited availability of best practices for conducting multisite research and recognizing the importance of identification of key intervention components, the current manuscript presents the traditional elements of an implementation paper along with secondary data analyses to identify drivers of the intervention's effects. Black, Latinx, and White mothers living with HIV (mean age = 39.27, SD = 7.89) and their children (51% female, mean age = 9.65, SD = 2.48) were recruited in Southern California and Atlanta (N = 176 dyads). Following baseline assessments, half were randomized to the intervention. Follow-up assessments occurred at 3, 9, and 15 months. Implementation and quality assurance protocols revealed the need for a broad range of recruitment and retention strategies, ongoing assessment of participants' psychological distress, and joint initial training of study personnel with ongoing supervision. Based on linear growth modeling, key intervention components (i.e., parent-child communication, positive parent involvement and reinforcement, family routines) significantly contributed to disclosure self-efficacy, the primary intervention target. Lessons learned emphasized the need to balance fidelity to the research protocol with strategies for managing site-based differences and the importance of including all key intervention components for future implementation at clinical or community-based sites.

Establishment of a cryopreservation method for the industrial use of D-amino acid oxidase-overexpressing Escherichia coli.

A cryopreservation condition for D-amino acid oxidase (DAAO)-overexpressing Escherichia coli (E. coli BL21(DE3)/pET-DAAO) was established. Ten percent was the optimum concentration of glycerol as a cryoprotectant, and its diffusion into stationary phase cells was superior to that into log cells. The results also showed that rather than fast cooling, a slow cooling method was appropriate to our recombinant E. coli. In addition, 15 min was the best equilibration period, at which higher than 90% of recovery rates were maintained at all test points. Most importantly, the relative recovery rates, product yield, and fermentation pattern of the cell banks (CBs) constructed according to our cryopreservation method did not change over 12 months, confirming that our method not only permits exceptional cryopreservation, but offers prolonged productivity. Taken together, our results demonstrating a cryopreservation method for E. coli BL21(DE3)/pET-DAAO provide insight into an improvement in the industrial production of DAAO.

An approach to strain improvement and enhanced production of clavulanic acid in Streptomyces clavuligerus.

To develop a strategy for improved production of clavulanic acid (CA), we investigated the effect of using oils on cell growth and CA production during the fermentation of Streptomyces clavuligerus NRRL 3585. In this analysis, triolein, whose fatty acid is oleic acid only, was the best oil source for CA production, but free fatty acids generated from the hydrolysis of oils in a culture broth negatively impacted CA production and cell growth. Hence, we screened for mutants that were resistant to high concentrations of oleic acid. From this screen we identified a mutant S. clavuligerus, OL13, that had a minimum inhibitory concentration (MIC) to oleic acid of 2.1 g/l, much higher than that of S. clavuligerus NRRL 3585, at 0.4 g/l. Not only was cell growth improved, but maximum CA production, at 1,950 mg/l, was approximately 2.0-fold higher than that of the parent strain.

The Use of Virtual Reality Technology in the Treatment of Anxiety and Other Psychiatric Disorders.

LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Evaluate the literature regarding the effectiveness of incorporating virtual reality (VR) in the treatment of psychiatric disorders• Assess the use of exposure-based intervention for anxiety disorders ABSTRACT: Virtual reality (VR) allows users to experience a sense of presence in a computer-generated, three-dimensional environment. Sensory information is delivered through a head-mounted display and specialized interface devices. These devices track head movements so that the movements and images change in a natural way with head motion, allowing for a sense of immersion. VR, which allows for controlled delivery of sensory stimulation via the therapist, is a convenient and cost-effective treatment. This review focuses on the available literature regarding the effectiveness of incorporating VR within the treatment of various psychiatric disorders, with particular attention to exposure-based intervention for anxiety disorders. A systematic literature search was conducted in order to identify studies implementing VR-based treatment for anxiety or other psychiatric disorders. This article reviews the history of the development of VR-based technology and its use within psychiatric treatment, the empirical evidence for VR-based treatment, and the benefits for using VR for psychiatric research and treatment. It also presents recommendations for how to incorporate VR into psychiatric care and discusses future directions for VR-based treatment and clinical research.

Physical electro-thermal model of resistive switching in bi-layered resistance-change memory.

Tantalum-oxide-based bi-layered resistance-change memories (RRAMs) have recently improved greatly with regard to their memory performances. The formation and rupture of conductive filaments is generally known to be the mechanism that underlies resistive switching. The nature of the filament has been studied intensively and several phenomenological models have consistently predicted the resistance-change behavior. However, a physics-based model that describes a complete bi-layered RRAM structure has not yet been demonstrated. Here, a complete electro-thermal resistive switching model based on the finite element method is proposed. The migration of oxygen vacancies is simulated by the local temperature and electric field derived from carrier continuity and heat equations fully coupled in a 3-D geometry, which considers a complete bi-layered structure that includes the top and bottom electrodes. The proposed model accurately accounts for the set/reset characteristics, which provides an in-depth understanding of the nature of resistive switching.

Assembly of a multichannel video system to simultaneously record cerebral emboli with cerebral imaging.

Stroke remains a significant risk of carotid revascularization for atherosclerotic disease. Emboli generated at the time of treatment either using endarterectomy or stent-angioplasty may progress with blood flow and lodge in brain arteries. Recently, the use of protection devices to trap emboli created at the time of revascularization has helped to establish a role for stent-supported angioplasty compared with endarterectomy. Several devices have been developed to reduce or detect emboli that may be dislodged during carotid artery stenting to treat carotid artery stenosis. A significant challenge in assessing the efficacy of these devices is precisely determining when emboli are dislodged in real time. To address this challenge, we devised a method of simultaneously recording fluoroscopic images, transcranial Doppler data, vital signs, and digital video of the patient/physician. This method permits accurate causative analysis and allows procedural events to be precisely correlated to embolic events in real time.